OBJECTIVE: To compare the value of three agents in terms of providing postoperative analgesia in patients having dilation and curettages. Their effects on hemodynamic parameters were evaluated. Recovery and sedation properties were also assessed. Design: Prospective, randomized trial Setting: University hospital Patients: Sixty three patients who underwent fractional curettage. Interventions: Diclofenac 1 mg/kg intramuscularly 30 minutes before induction and tramadol 1 mg/kg intravenously 15 minutes before induction were given in group 1 and 2, respectively. The third group received fentanyl 1 μg/ kg intravenously for induction. Then, induction was provided with propofol 2 mg/kg and % 50 air and % 50 oxygen given with face mask. For anesthesia management 20% of the induction dose of propofol was used intermittently. Main outcome measures: Peroperative and postoperative haemodynamic parameters and SPO2 were recorded. Visual Analog Scale 0-10 cm, sedation score 0-4 point, Aldrete recovery scores 1-10 were assessed postoperatively at the 1, 5, 15, 30, and 120th minutes. RESULTS: Peroperative and postoperative hemodynamic parameters showed no difference. The scores obtained by using Visual Analog Scale were also similar in all groups. There were no differences in sedation and Aldrete recovery scores in the three groups. On the other hand, propofol consumption was significantly lower in the fentanyl group when compared with the other two groups. CONCLUSION: Fentanyl usage decreased the amount of propofol when compared with diclofenac and tramadol administration. However, both tramadol and diclofenac were associated with lower amount of supplementary analgesic agents. They are both nonnarcotic analgesics. Therefore, preference of these two agents may be regarded more favorable.
Keywords: curettage, diclofenac, fentanil, postoperative analgesia, tramadol