Effects of preemptive intravenous dexketoprofen adding, on postoperative pain and opioid consumption in patients with interscalene block in arthroscopic shoulder surgery

Background: Postoperatif pain is an important problem for patiens who uderwent shoulder surgery. In our study we investigate analgesic effiency, analgesy time, postoperative analgesic usage and patient satisfaction on preemptive i.v deksketoprofen usage for interscalene block (ISB) in addition to general anasthesia in arthoscopic shoulder surgery. Methods and material: After accuring Faculity Ethic Committee Permission 60 patients included to study who are 18-65 years old, accepted to join study and ASA (American Society of Anesthesiologists) I-II group scheduled artroscopic shoulder surgery. The patients were randomly divided into two groups. Groups are assigned as Group 1 is control and Group 2 is deksketoprofen group. 15 minutes prior to incision 100 ml %0.9 NaCl i.v infusion given to group 1. Also15 minutes prior to incision 50mg deksketoprofen in 100 ml %0.9 NaCl i.v infusion given to group 2. In all cases after single-shot ISB general anesthesia was given. For ISB 20 ml (lidocaine %2 10ml and bupivacaine %0.5 10ml mixture) given. Intravenous PCA was used to generate postoperative analgesia. Postoperative follow up of cases done by a researcher who has no knowledge of study. Postoperatif pain assessed on 15 min., 30 min., 45 min., 1h, 2h, 4h, 8h, 12h, 24h and 48 h. Postoperative sensory block duration of the shoulder joint was determined as the time to the start of pain at the site of the incision because postoperative bandage and shoulder bandage were to be applied to the surgical field. The postoperative motor block duration of the shoulder joint was determined as the time until the patients were able to move their shoulders first or to perform forearm flexion. Results: Comparison of groups by demographic and hemodynamic datas shown no significant difference statistically. Comparing groups by motor block time and sensory block time, there is no statical difference for motor block time. But for sensory block time there is statistically meaningful difference in favor of deksketoprofen group (p<0.05) which have longer times. Comparison of VAS score shown statistically meaningful difference in favor of deksketoprofen group which have lower score in all times (p<0.05). Also 45 min. and 4 h VAS score p<0.001, 48.h p<0.000. Total PCA fentanyl dose (μg) between groups, deksketoprofen group is 274.16 ± 314.89, control group is 490.00 ± 408.98 and there is a statically meaningful difference (p<0.05). Conclusion: In artroscopic shoulder surgery applying interscalene block produce more effective analgesy on postoperative period. İn addition to block, preempitive i.v deksketoprofen usage provide longer sensory block time, less postoperative pain and more patient satisfaction than interscalene block alone. Usage of preempitive i.v deksketoprofen can be good choice because it is easy to use, less likely to cause side effect or complication and provide effective analgesia.