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IV diclofenac in post-thoracotomy pain
K Perttunen1, E Kalso, J Heinonen
1Department of Anaesthesia, Helsinki University Central Hospital.
British Journal of Anaesthesia
|May 1, 1992
Summary
Continuous intravenous diclofenac infusion significantly reduced opioid use and improved pain relief after thoracic surgery. This method offers superior analgesia and better oxygenation, with no adverse effects on bleeding.
Area of Science:
- Anesthesiology
- Pharmacology
- Thoracic Surgery
Background:
- Post-thoracic surgery pain management is challenging.
- Opioid-based analgesia is common but associated with side effects.
- Non-invasive pain relief alternatives are needed.
Purpose of the Study:
- To evaluate the efficacy of continuous intravenous diclofenac infusion for pain management after major thoracic surgery.
- To compare diclofenac's effect on opioid consumption, analgesia, and respiratory function against placebo.
Main Methods:
- Double-blind, placebo-controlled, parallel-group study.
- 30 patients undergoing major thoracic surgery received either diclofenac (2 mg/kg/24h IV for 2 days) or placebo.
- Patients had access to patient-controlled analgesia (PCA) morphine for breakthrough pain.
Main Results:
- Diclofenac group showed a 60-76% reduction in morphine consumption compared to placebo.
- Superior overall analgesia and improved arterial oxygenation in the diclofenac group.
- No significant impact on bleeding or platelet function; transient decrease in urine output observed, with normal renal function.
Conclusions:
- Continuous IV diclofenac infusion is a valuable adjunct to PCA opioids for post-thoracic surgery pain relief.
- It offers improved analgesia and respiratory function without compromising hemostasis.
- Caution is advised in patients at risk for acute renal failure when using NSAIDs.