Multimodal analgesia in minimally invasive echo-controlled surgeries about purulent complications of acute pancreatitis

Abstract

Prerequisites and goals: Pain is one of the main symptoms of acute pancreatitis (AP), which requires appropriate analgesia. Multimodal analgesia (MMA) is used for this purpose. Experimental and clinical data indicate the high efficiency of dexketoprofen not only as a systemic but also as a local anesthetic. The aim of the study was to evaluate the effectiveness of MMA with dexalgin (dexketoprofen) when performing minimally invasive echo-controlled surgeries (MIES) for purulent complications of AP.Methods: The study involved 100 patients. The comparison group (50 people) consisted of patients in whom MIES was performed under local anesthesia with 2% lidocaine, ketoprofen (200 mg daily) was used intramuscularly after it. In the main group (50 people) patients received dexalgin (150 mg daily) topically during the MIES and intramuscularly after it. In case of inefficiency of treatment, patients received opiates. The effectiveness of treatment was assessed using visual analog scales and blood cortisol. Results: MMA was quite sufficient for patients of the main group. Opiates was required in 12 patients of the comparison group (24%). Patients of this group rated pain during the first day in 2.5±0.3 points, the main group - 2.1±0.3 points. Blood cortisol levels after the intervention were: after 3 hours main group - 355.6±21.3, comparison group - 534.3±16.3, after 6 hours respectively - 431.2±8.2 and 600.2±15.7, after 12 hours respectively - 559.3±8.3 and 658.5±12.6 (p<0.0001). Conclusions: MMA by dexalgin in MIES is highly effective in patients with complicated AP. Key words: complicated acute pancreatitis, minimally invasive surgeries, multimodal analgesia