Efficacy of the Association of Dipyrone and Meperidine in Decreasing the Need of Opioid in Acute Postoperative Pain after Abdominal Surgery
Abstract
Introduction. The main concern of patients who undergo surgery is postoperative pain, for which opioids are the most common medication used even though their side effects limit their use. In Colombia, pain is managed by general practitioners or surgeons who mainly use dipyrone with suboptimal results. A safe alternative with minimal side effects could be the addition of meperidine to dipyrone which could be used by non specialists.
Objective. To determine if the addition of meperidine to dipyrone decreases in 50 % the opioid requirements to achieve an effective postoperative pain management.
Methods. A controlled clinical trial with 107 patients distributed in two groups was performed. The study group received 0.5 mg per kilogram of meperidine plus 2.5 g of dipyrone (n = 57), and the control group received the usual dose of 1 mg per kilogram of meperidine (n = 50). Postoperative pain was assessed with the visual analog scale (VAS).
Results. The incidence of acute postoperative pain was 28 % in the study group and 26.3 % in the control group. The relative risk (RR) was higher in the study group (RR = 1.06; confidence interval 95 % 0.57-1.98), without difference between them. The incidence of side effects had a higher RR in the control group with a significant difference (p = 0.0055).
Conclusions. The combination of dipyrone and meperidine allows a 50 % reduction in the need of opioid with lesser side effects. However, postoperative pain was not effectively controlled.
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