Intravenous ketoprofen in thyroid and parathyroid surgery

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Pharmacology

Background:

• Postoperative pain management after thyroid and parathyroid surgery often involves multimodal analgesia.
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ketoprofen may offer benefits but their impact on bleeding risk in this specific surgery is a concern.

Purpose of the Study:

• To evaluate the efficacy and safety of ketoprofen-propacetamol combination versus propacetamol alone for postoperative pain, bleeding, and nausea/vomiting after thyroid and parathyroid surgery.

Main Methods:

• A prospective open study comparing two groups: one receiving ketoprofen-propacetamol and a control group receiving propacetamol alone.
• Standardized anesthetic techniques and postoperative analgesia protocols were used, with morphine rescue for pain scores above 40.
• Pain scores, opioid consumption, and cervical drainage fluid (volume, hemoglobin concentration, and mass) were recorded over 24 hours.

Main Results:

• The ketoprofen group reported significantly lower pain scores and required less morphine (7.4 vs 11.7 mg).
• Fewer episodes of nausea and vomiting were observed in the ketoprofen group (21 vs 38).
• No significant difference in cervical bleeding was found between groups, though two hematomas occurred in the control group.

Conclusions:

• Ketoprofen, when combined with propacetamol, effectively reduces postoperative pain and associated adverse effects like nausea and vomiting.
• The ketoprofen-propacetamol combination appears safe for thyroid and parathyroid surgery, showing no increased risk of cervical bleeding.