Pre-Operative versus Postoperative Surgical Analgesia


Hiwa Omer Ahmed1, Ako Ibrahim Muhemad2

College of Medicine, University of Sulaimani, 2 Sulaimani Teaching Hospital Kurdistan Region\ Iraq  


Abstract
Background; postoperative pain remain the most common dilemma for surgical patients, there are many
methods for control of pain, either by conventional postoperative analgesia or preoperative analgesia.
The aim; is to evaluate the benefit of Diclofenac as pre-operative analgesia in comparison to the
postoperative conventional treatments.
Methods and Patients; this study includes patients of different age and sex groups, underwent different
elective and emergency surgical operations,
They divided in to two groups:
- Group A (100 patients): controlled group, were received pre-operative analgesia.
- Group B (100 patients): compared group, were received the conventional analgesia.
Results; thirty eight percent of patients in group A have significant pain versus eighty six percent of the
patients in group B (P value 0.0000)
Preoperative analgesia as single dose of Diclofenac is more effective in control of postoperative pain
than conventional postoperative analgesia.
Conclusion; we could say that the pre-operative (pre-emptive) analgesia is safe, feasible, well tolerant,
less costly and more effective for the control of different types of the surgical pain.

Keywords; pain, pre-emptive analgesia, conventional analgesia. Diclofenac.

References 
1. Ronald D. Miller; "Anesthesia" .5th edition; 2000; 3; P 2323, by Churchill Livingston,. New York 
2. Russell. Bailey & Love" Short Ppacice of Surgery" 24th Edition 2004, 52, 1446-1448. Anold,  
3. Mark C. Horattas et al. /Pre-empetive analgesia The American Journal of surgery  2004, 188, 271-276. 
4. Jale Bengi Celik, Niyazi Gormus, Zulfikare Isik Gormus, Selmin Okesli and Hasan  Solak:,treating postoperative pain by preventing the establishment of central sensitizationThe Journal of Cardiothoracic and vascular anesthesia,2005,19(1),67-70. 
5. Allan Gottschalk: Up date on preemptive analgesia anesthesiology;2003,7,  116-121.  6. Gottschalk A, Smith DS: New Concepts in acute pain therapy: Preemptive analgesia     Am Fam Phys 2001; 63:1079-1084.  
7. Holger Holthusen, Peter Backhaus, Frank Boeminghaus, Maria Breulmann, and Peter  Lipfert: Preemptive Analgesia: No relevant advantage of preoperative compared with postoperative intravenous administration of morphine,ketamine, and clonidine in patients undergoing transperionial tumor  nephrectomy: Regional Anesthesia and Pain Medicine, 2002, 27(3)  , 249-253.                                                             
8. Chandra K.Pandey,Shio Priye, Surendra Singh, Uttam Singh, Ram B. Singh, Prabhat      K. Sigh; Preemptive use of gabapentin significantly decreases post operative pain and rescure analgesic requirement in laparoscopic cholecystectomy; Can J Anesthesia 2000 ,51( 4)  358-363.                                                                                                                                 
9. Puura A, Puolakka P, Rorarius M, Salmelin R, Lindgren Etoricoxib pre-medication for post-operative pain after laparoscopic cholecystectomy.Acta Anaesthesiol Scand.   2006,50(6):688-93.  
10. Slingsby LS, Murison PJ, Goossens L, Engelen M, Waterman-Pearson AE. A       comparison between pre-operative carprofen and a long-acting sufentanil       formulation for analgesia after ovariohysterectomy in dogs.Vet Anaesth Analg.  
2006 33(5):313-27  
11. Bonaventura MA, Vallejo MC, Phelps AL, Sah N, Romeo RC, Falk JS, Johnson       RR, Edington HD,Keenan ,DM Preemptive analgesia with bupivacaine for segmental mastectomy.Reg Anesth Pain Med. 2006 ,31(3):227-32  
12.MSParina Bajaj,MDChetna,Comparison of the effects of parecoxib and diclofenac in preemptive analgesis,Current Therapeutic Research, 2004, 65,issue 5,:383-397,