Intravenous ketoprofen as an adjunct to patient-controlled analgesia morphine in adolescents with thoracic surgery: a placebo controlled double-blinded study.

BACKGROUND

Surgery to correct pectus deformities entail substantial destruction of the thoracic skeleton and thus may cause significant postoperative pain.

AIMS

To evaluate the efficacy of intravenous ketoprofen, a NSAID, as an adjunct to PCA morphine in pain treatment in children having pectus surgery.

METHODS

Thirty-one children aged 10-15 years completed the study according to protocol. Children (n=14) in the ketoprofen-group received ketoprofen 1mg/kg i.v. at the skin closure, and at 8 and 16 h after surgery, while children (n=17) in the placebo-group received normal saline, respectively. For rescue analgesia the patient had an access to PCA-morphine. The children expressed their pain by a coloured VAS.

RESULTS

Mean cumulative 24h morphine dose used was less in the ketoprofen-group (mean+/-SD: 490+/-240 microg/kg) than in the placebo-group (670+/-200 microg/kg) (mean difference 180 microg/kg, 95% CI for diff: 15-340 microg/kg, P=0.03). The area under the pain intensity-time-curve was lower in the ketorpofen-group (49+/-26 score hour) than in the placebo-group (68+/-24 score hour) (mean difference 21 score hour, 95% CI for diff: 3-40 score hour, P=0.026). There was no difference between the two groups in adverse events, 4/14 in the ketoprofen group and 8/17 in the placebo-group developed oxygen desaturation, and one patient in the ketoprofen-group developed bleeding at 5h after surgery.

CONCLUSIONS

Intravenous ketoprofen in adjunct to PCA morphine provided a significant opioid sparing effect and improved analgesia in children having chest wall correction surgery.