Prämedikation mit Etoricoxib und Tapentadol und deren Auswirkung auf die Reduktion postoperativer Schmerzen

In der modernen Schmerztherapie gewinnen Patientenzufriedenheit und Wirtschaftlichkeit immer mehr an Bedeutung. Bei der Vielzahl von Analgetika ist es daher notwendig, deren Verwendung im Rahmen von Standard Operating Procedures regelmäßig zu evaluieren. Auch gilt es, die Zufriedenheit der Behandelt...

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Bibliographic Details
Main Author: Peupelmann, Sabine
Contributors: Eberhart, Leopold (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2016
Online Access:PDF Full Text
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Table of Contents: Patient satisfaction and efficiency are continuously gaining in importance in modern pain management. Therefore, it is necessary to evaluate the usage of the majority of analgesics within the scope of Standard Operating Procedures on a regular basis. Furthermore, it is important to take into account the satisfaction of the patient, as the success of a medical procedure from the patient’s point of view is accompanied by the consistent treatment of the symptoms and therefore serves the image of medical centers. The goal of the study was to assess the impact of preoperative administration of 90 mg Etoricoxib and 100 mg Tapentadol on the reduction of postoperative pain in the ear, nose and throat region in comparison to a standardized perioperative pain treatment (Metamizole, Piritramide, Ibuprofen). Moreover, the dimensions Physical Ailments, Autonomy and Pain were evaluated by means of the PPP33 survey. Patients were questioned about their pain in the area of operation within 24 to 48 hours after the procedures. Measuring instrument was the numeric rating scale. They were required to make three ratings; one for immediate postoperative pain, one for pain in the process, as well as the pain at the current point in time. In addition, patients received the PPP33 survey, which serves as a routine surveying tool at the university hospital Marburg for the evaluation of perioperative quality during a hospital stay. The result were 734 completely analyzable sets of data. At a percentage of 39% female patients and 61% male patients between the ages of 18 to 92, 315 people received a combination of Etoricoxib and Tapentadol. At a p-value of 0,0006 this resulted in a significant reduction of postoperative pain. There was no significant reduction noticeable in terms of pain in the process, current pain or postoperative analgesics consumption. Furthermore, there was no decrease in postoperative physical ailment or increase in perceived autonomy during the hospital stay after premedication with Etoricoxib and Tapentadol. As a consequence of those results it can be concluded that it subsequently needs to be examined which part each medication plays in postoperative pain reduction, so that the pain medication can be reduced to one drug that the patient will receive for consistent pain management during their hospital stay. The future goal should be to adjust the medicinal regime and review it on a regular basis in a way that it contributes to the ideal analgesia. Additionally, these should increase the perioperative quality as well as the well-being of the patient during their hospital stay and therefore satisfy the needs and expectations of the patients.