Samulak, D., Michalska, M., Gaca, M., Wilczak, M., Mojs, E., & Chuchracki, M. (2011). Efficiency of postoperative pain management after gynecologic oncological surgeries with the use of morphine + acetaminophen + ketoprofen versus morphine + metamizol + ketoprofen. European Journal of Gynaecological Oncology, 32(2), 168–170.
To compare the efficacy of two medication schemes for the management of pain after gynecologic surgery
Consecutive patients were randomly assigned to two groups. Group 1 received, on the day of surgery, 1 mg morphine/10 kg body mass subcutaneously (SC) every four hours. After surgery Group 1 received 1 g acetaminophen IV every six hours and 500 mg naproxen per rectum every 12 hours daily. Group 2 received 1 mg morphine/10 kg body mass SC every 4 hours, 1 g metamizol IV every 6 hours, and 500 mg naproxen per rectum every 12 hours. For all patients, in instances of pain rated 5 or more, an additional 100 mg of ketoprofen IV was administered. Pain was rated throughout hospitalization.
Randomized parallel group
Numeric pain rating scale of 0–10
For the management of postoperative pain following gynecologic surgery, the combination of morphine, acetaminophen, ketoprofen, and metamizol as used in this study was more effective than the combination of morphine, metamizol, and ketoprofen.
This study describes a perioperative pain management regimen that appears to have decreased the pain of patients who underwent extensive gynecologic surgery. Note, however, that the more effective regimen did not provide complete control for more than 30% of patients on the day of surgery and for more than 15% on the first postoperative day. This study adds to the growing research regarding perioperative adjuvant medications for acute pain control.