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Intravenous diclofenac sodium decreases prostaglandin synthesis and postoperative symptoms after general anaesthesia in outpatients undergoing dental surgery
Author(s) -
Valanne J.,
Korttila K.,
Ylikorkala O.
Publication year - 1987
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1987.tb02652.x
Subject(s) - medicine , anesthesia , diclofenac , diclofenac sodium , saline , lidocaine , general anaesthesia , placebo , isoflurane , prostaglandin , surgery , pharmacology , alternative medicine , pathology
One hundred unpremedicated patients scheduled for outpatient restorative dentistry and/or oral surgery were given either 75 mg diclofenac sodium (prostaglandin synthesis inhibitor) or a saline placebo i.v. in a double‐blind random fashion before induction of anaesthesia with methohexitone (2 mg/kg). Intubation was facilitated with suxamethonium (1.2 mg/kg) and anaesthesia was maintained with isoflurane in 50% nitrous oxide and oxygen using spontaneous respiration. Cuff pressure was continuously monitored and maintained at 10–25 mmHg. The mean duration of anaesthesia was 141 ± 75 min in the diclofenac group and 150 ± 73 min in the saline group. Diclofenac inhibited prostaglandin synthesis, as evident from serum thromboxane B 2 and urinary 6‐keto‐prostaglandin F 1α data. There was no difference in recovery as assessed from the orientation time (14.2 ± 5.7 min and 14.5 ± 6.3 min for diclofenac and saline patients, respectively), perceptual speed and ability to walk along a straight line 30 and 60 min after anaesthesia. Emetic symptoms were equally common in both groups: an overall incidence of 32.6% and 36.7% for the diclofenac and saline patients, respectively. In the whole patient series women became nauseated and vomited more than men ( P <0.01). Diclofenac reduced the incidence of pain in the throat or oral region I h after anaesthesia ( P <0.05) and other symptoms 1–24 h postoperatively ( P <0.01). Thus, preoperative intravenous diclofenac appears useful in ambulatory patients undergoing restorative dentistry and oral surgery under isoflurane anaesthesia.