Suggestive Preparation of Patients using Intravenous Ketoprofen as a Part of Postoperative Pain Management in Elective Abdominal Surgery

Abstract

Suggestive preparation before surgery may have a placebo effect and can reduce perioperative consumption of analgesics. A total of 77 adult patients undergoing elective cholecystectomy and hernioplasty were included in this prospective study. All patients were given 100 mg of ketoprofen intravenously and were assigned to two groups. The first group was not informed about analgesia (no preparation, NP group), and the second group were told that they will receive a strong painkiller (suggestive preparation, SP group). Pulse rate, blood pressure and VAS scores were registered in all patients immediately before anesthesia induction in the operating room (T1), after waking up in the recovery room (T2), 6 hours after surgery at the surgical ward (T3) and on the morning after surgery in the surgical ward (T4), at rest and during movement. Rescue nonsteroidals were offered to patients with VAS 3-4, and opioids for VAS ≥5. The patients in the SP group had lower VAS scores in all measurements and lower opioid consumption. A statistically significant difference was observed in VAS2 measurement during movement (3 [2-5] vs. 2 [0-3.75] in the NP and SP group, P=0.008). SP had a placebo effect and reduced VAS scores as well as opioid consumption.

Keywords

• placebo effect
• suggestion
• ketoprofen
• acute postoperative pain
• visual analog scale