Document Detail


Acute postoperative swelling after hand surgery: an exploratory, double-blind, randomised study with paracetamol, naproxen, and placebo.
MedLine Citation:
PMID:  11291357     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A model using volumetry to evaluate the effect of drugs on acute postoperative swelling after operations for primary Dupuytren's contracture (DC) and carpal tunnel syndrome (CTS) was established and validated. The temperature of the saline and time of measurement during the day influenced the volumetric readings. The error of measurement after volumetry of unoperated and operated hands after operations for DC was 0.7% and 0.6%, respectively. Naproxen (500 mg twice a day), paracetamol (1000 mg four times a day), or placebo were given postoperatively for three days to 35 patients after DC and 42 patients after CTS in a randomised, placebo-controlled study. Hand volume was measured preoperatively and 72 hours after surgery. There was a difference in swelling (p = 0.009) indicating different degree of development of swelling 72 hours postoperatively between the DC and CTS placebo groups, which invalidated pooling of the data. After operations for DC naproxen was slightly but not significantly superior to paracetamol and placebo, with paracetamol numerically superior to placebo. The power of the study, caused by the limited number of patients included, does not permit this difference to reach significance. Operations for CTS caused so little swelling that comparisons were invalidated. Naproxen treatment, irrespective of type of operation, did not require rescue analgesics, while two patients after CTS treated with paracetamol did. Two and six placebo-treated patients required rescue drugs after operations for DC and CTS, respectively. We conclude that naproxen might have a clinical relevant effect on swelling when used on minor surgery in the hand, unlike paracetamol. Naproxen might be a useful analgesic during the immediate postoperative phase.
Authors:
T Husby; J R Haugstvedt; G Fyllingen; L A Skoglund
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi     Volume:  35     ISSN:  0284-4311     ISO Abbreviation:  Scand J Plast Reconstr Surg Hand Surg     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-04-06     Completed Date:  2001-07-26     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8707869     Medline TA:  Scand J Plast Reconstr Surg Hand Surg     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  91-8     Citation Subset:  IM    
Affiliation:
Orthopedic Center, National Hospital, Oslo, Norway. torstein.husby@ioks.uio.no
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / therapeutic use*
Adult
Aged
Aged, 80 and over
Analgesics, Non-Narcotic / therapeutic use*
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Carpal Tunnel Syndrome / surgery*
Double-Blind Method
Dupuytren Contracture / surgery*
Edema / prevention & control*
Female
Hand / surgery*
Humans
Inflammation / prevention & control
Male
Middle Aged
Naproxen / therapeutic use*
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Anti-Inflammatory Agents, Non-Steroidal; 103-90-2/Acetaminophen; 22204-53-1/Naproxen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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