A Comparative Study of the Efficiency of Using Non-Selective Nonsteroidal Anti-Inflammatory Drugs in Patients with Endoprosthetic Total Knee and Hip Arthroplasty

Abstract

Objective: to compare the postoperative efficacy and safety of non-selective nonsteroidal anti-inflammatory drugs in patients undergoing endoprosthetic total knee and hip arthroplasty (ETKAP and ETHAP). Subjects and methods. The study included 60 patients who were referred for ETKAP or ETHAP and randomly assigned to 3 groups. Groups 1, 2, and 3 patients were anesthetized with ketorolac, metamizol, and paracetamol, respectively. Real-time evaluation of the efficiency of postoperative analgesia was carried out within 3 days after surgery; the patients were questioned about bowel function, the onset of the first active movement in the ward, and occurring unpleasant sensations. Results. Reduced or no appetite was more common in the paracetamol and metamizol groups than in the ketorolac; the paracetamol group was found to have dizziness in 20% of cases, which was not observed in the two other groups. The patients who started to have routine hospital diet in the first 24 postoperative hours were significantly fewer among the paracetamol-treated patients. The shortest time to the first active movement was observed in the ketorolac group, which corresponded to the end of the first 24 hours and significantly distinguished it from the other groups. This appeared to be due to the best analgesic effect that, after epidural block, was significantly more effective (according to VAS scores) in the ketorolac group, if not enhanced in any group, which agrees with information available on the drug as a worthy alternative to opioids due to its valid analgesic effect. Conclusion. __Intravenous ketorolac is a worthy alternative to narcotic analgesics in ensuring the comfortable course of the immediate postoperative period in patients operated on the knee and hip joints. Key words: ketorolac (ketorol), postoperative analgesia, endoprosthetic knee and hip arthroplasty.