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The Effect of Intravenous Dexketoprofen on the Severity and Incidence of Rebound Pain

10. juni 2026 opdateret af: Çağla Uzalp, Eskisehir Osmangazi University

Evaluation of the Effect of Intravenous Dexketoprofen on the Severity and Incidence of Rebound Pain in Patients Undergoing Interscalene Brachial Plexus Block

Orthopedic shoulder surgeries are associated with severe postoperative pain, particularly within the first 24-48 hours after surgery. In postoperative pain management, single or continue interscalene brachial plexus blocks, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids administered as needed are commonly used as components of multimodal analgesia.

Rebound pain is defined as severe postoperative pain (VAS ≥ 7) occurring within the first 24 hours after resolution of the block. It is considered an adverse effect of regional anesthesia and typically develops 8-12 hours after a single-shot nerve block. Risk factors for rebound pain include pre-existing pain, female sex, younger age, bone surgery, lack of intraoperative dexamethasone administration, and inadequate analgesia.

The primary objective of this study is to evaluate the effect of intravenous dexketoprofen administered during the postoperative period on the incidence and severity of rebound pain in patients undergoing shoulder surgery with interscalene brachial plexus block

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Sixty-six patients undergoing rotator cuff repair will receive standardized ISB and general anesthesia for the surgery.All patients will be administered 0.03 mg/kg of midazolam during the preoperative period and an interscalene brachial plexus block will be administered using 10 cc of %0.5 bupivacaine and 5 ml of normal saline.During induction under general anesthesia, the following will be administered: lidocaine 1 mg/kg, propofol 2-3 mg/kg, rocuronium 0.6 mg/kg, and remifentanyl 0.5 mcg/kg. Maintenance of anesthesia will be provided using a mixture of %2-3 sevoflurane, %50 air, and %50 oxygen, maintaining the bispectral index between 40 and 50.

Heart rate and blood pressure values will be titrated by increasing or decreasing the remifentanil infusion to ensure that the values remain within %20 of baseline or that the OAB remains above 65.

If the mean arterial pressure drops by more than %20, 5 mg of ephedrine will be administered.

At the end of the procedure, the surgical duration and the total intraoperative remifentanil dose administered will be recorded.

In the postoperative recovery room, patients who show no loss of sensation in the C5-C6 dermatome (over the deltoid muscle) on the pinprick test but report severe pain (VAS ≥ 4) will be considered to have had a failed block.

Under the postoperative analgesia protocol all patients will be equipped with an IV morphine patient-controlled analgesia (PCA) device. The solution will be prepared such that morphine is 0.5 mg / ml. PCA 1mg bolus dose will be delivered with 10 min lock-out time and all patients will be administered 1 gram of paracetamol at 8th 16th and 24th hours.

Patients will be randomly divided into 2 groups as Group K(Patients not receiving nonsteroidal anti-inflammatory drugs) and Group D(Patients receiving nonsteroidal anti-inflammatory drugs) In Group D (Patients receiving nonsteroidal anti-inflammatory drugs) cases, will be administered 25 miligram of dexketroprofen at 6th and 18th hours.

In the postoperative period, a researcher assessed the patient's visual pain scores (resting and movement), rebound pain intensity, timing, and duration, systolic blood pressure, mean arterial pressure, diastolic blood pressure, peripheral oxygen saturation, postoperative analgesic consumption, and postoperative complications will be recorded.

Patient follow-up will be concluded at the end of 24 hours.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

66

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

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Studiesteder

  • Tyrkiet (Türkiye)
    • Odunpazarı
      • Eskişehir, Odunpazarı, Tyrkiet (Türkiye), 26040
        • Eskisehir Osmangazi Universıty Faculty of Medicine
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Çağla Uzalp

Deltagelseskriterier

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Beskrivelse

Inclusion Criteria:

Age 18-70 years ASA score of I-III Arthroscopic shoulder surgery

Exclusion Criteria:

Patients who do not wish to participate in the study Creatinine clearance <50 mL/ min Patients for whom NSAID use is contraindicated due to heart failure, Patients with psychiatric or cognitive dysfunction that would impair their ability to assess visual analog scale (VAS) pain scores Patients for whom peripheral nerve block is contraindicated

Studieplan

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Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Placebo komparator: Group K
Under the postoperative analgesia protocol all patients will be administered 1 gr of paracetamol at 8th 16th and 24th hours and all patients will be equipped with an IV morphine patient-controlled analgesia (PCA) device.
Medicin: ISB + paracetamol IV 3*1
ISB + paracetamol IV 3*1
Aktiv komparator: Group D
Under the postoperative analgesia protocol all patients will be administered 1 gram of paracetamol at 8th 16th and 24th hours and all patients receiving nonsteroidal anti-inflammatory drugs (25 miligram of dexketroprofen) at 6th and 18th hours. The patients will be equipped with an IV morphine patient-controlled analgesia (PCA) device.
Medicin: ISB+ paracetamol IV 3*1 +deksketoprofen IV 2*1
ISB+ paracetamol IV 3*1 +deksketoprofen IV 2*1. 25 miligram of dexketroprofen

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Effect of intravenous dexketoprofen administered during the postoperative period on the severity and incidence of rebound pain
Tidsramme: 24 hours
Rebound pain score(VAS ≥ 7) and incidence
24 hours

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total opioid consumption
Tidsramme: 24 hours
Total morphine patient control analgesia prepared 0.5 mg / ml. PCA 1 mg bolus dose will be delivered with 10 min lock-out time. Follow up morphine consumption at postoperative 24 hours
24 hours
Visual analog Scale
Tidsramme: 24 hours
Visual analog scale at rest and movement (0 (no pain)-10 (unbearable pain))
24 hours

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Sponsor

Eskisehir Osmangazi University

Efterforskere

  • Studiestol: MERYEM ONAY, Eskisehir Osmangazi University Faculty Of Medıcıne

Publikationer og nyttige links

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Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

13. maj 2026

Primær færdiggørelse (Anslået)

30. oktober 2026

Studieafslutning (Anslået)

30. oktober 2026

Datoer for studieregistrering

Først indsendt

1. juni 2026

Først indsendt, der opfyldte QC-kriterier

10. juni 2026

Først opslået (Faktiske)

11. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

11. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. juni 2026

Sidst verificeret

1. juni 2026

Mere information

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Nøgleord

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  • Esogü95

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Kliniske forsøg med Postoperativ smerte

Kliniske forsøg med ISB + paracetamol IV 3*1

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