Volume : VII, Issue : III, March - 2018

Patient controlled analgesia (PCA) using non–opioid analgesics after primary thyroid surgery – an Endocrine surgical unit experience

Dr. S. Tamilselvan, Dr. K. Rajachidambaram, Dr. S. K. Manoj, Dr. Gowtham

Abstract :

 

Background:

         Pain is an inflammatory response that leads to the release of various inflammatory mediators results in systemic inflammatory response syndrome as well as appropriate wound healing.

In the context of patient’s recovery and wound healing an adequate pain control plays a major role in post–operative management. The routine prescription of analgesics for duration of 5–7 post–operative days without adequate pain assessment is a common surgical practice in India. The usage of too much analgesia especially Opioid based has its own side effects as well as it adds more financial burden to patients. Hence, the analgesic needs to be prescribed appropriately as per the clinical situation with patient involvement rather than routinely.

Aim of the study:

         To evaluate the efficacy and clinical use of  single dose of analgesia Diclofenac sodium 100mg in the form of rectal suppositories during the early post–operative period( first hour after extubation) and thereafter when required basis based on patient visual analogue scoring(VAS) during the post–operative period in patients undergoing primary thyroid surgeries in our surgical unit.

Materials and Methods:

         A prospective study was performed over a period of two years (August 2015 – September 2017). The study population patients were educated pre operatively regarding the Visual analogue score and their psychometric response in the post–operative period were recorded. All the surgeries were performed by a single endocrine surgeon in a private referral center. The study included all primary thyroid surgeries and redo thyroidectomies and total thyroidectomy with neck node dissections were excluded from the study. The post–operative psychometric response of the patient were recorded thrice daily for one week. The analgesic requirement and the VAS were reviewed prospectively.

 

Results:   

        A total of 170 thyroid surgeries were performed. Of which, 120 were included in the study and the rest were excluded on the basis of exclusion criteria. Among 120 cases, 20 were male and 100 were female patients (male: female = 1: 5) and the age range from 25 years to 54 years. There were 76 total thyroidectomy and 46 hemi thyroidectomy procedures. A total of 11 out of 120 patients (9.1 %)   required additional variable doses of simple oral analgesics.

Conclusion:

      Our study has shown that primary thyroid surgeries does not require routine intense dose of analgesics during post–operative period. Single dose of analgesia can be very effective in post–operative pain control and additional doses can be added as per the need of the patient and this proved to be satisfactory, cost effective and also avoids analgesic induced side effects.

 

Keywords :

Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

DR.S.TAMILSELVAN, DR.K.RAJACHIDAMBARAM, DR.S.K.MANOJ, Dr.Gowtham, Patient controlled analgesia (PCA) using non–opioid analgesics after primary thyroid surgery – an Endocrine surgical unit experience, INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-7 | Issue-3 | March-2018

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