Synergistic Effect of a Selective Serotonin Reuptake Inhibitor and a Selective Cyclo-Oxygenase-2 Inhibitor on Post Spinal Anesthesia Headache

R. F. Iteke, D. Mutombo, Franck Namegabe Zirhumana, O. Mukuku, E. Muyumba, Tinsley Mukakala Kibonge, J. Brichant, A. Kilembe, Y. Brouh, J. Kakoma
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Abstract

Objective: To evaluate the synergistic effect of a Selective Serotonin Reuptake Inhibitor (SSRI) and a Selective Cyclooxygenase 2 Inhibitor (ISCOx-2) in the management of After Rachianesthesia Headache in Obstetric Care. Patients and Methods: This was an experimental double-blind, randomized, multi-center clinical trial of non-inferiority clinical trials over a 12-month period (May 1, 2018 to April 30, 2019) in six hospitals in southeastern DR Congo, including all patients undergoing surgery or analgesia on spinal anesthesia for obstetrical indication and with headache characteristic of a dural breccia, with no known causes, contraindications to experimental products and informed consent to been obtained. The patients were divided into four different groups depending on the protocol used, namely: Group A = Rehydration + Paracetamol, Group B = Rehydration + Celecoxib, Group C = Rehydration + Nefopam and Group 4 = Rehydration + Celecoxib + Nefopam (Study Group). Using the Statview II software, the statistical analyzes of data obtained from the different tests were made using the ANOVA test for comparing the averages of different samples using the Fisher test. Verification of the normality of the samples was made by the Kurtosis and Skewness flattening and asymmetry test. Results: The protocol associating Celecoxib and Nefopam significantly demonstrates its effectiveness in reducing CPRAOs in the first two days with a gradual decrease in anxiety and length of stay. In addition, the majority of patients (75.6%) had a high overall level of satisfaction with this protocol. Conclusion: The Nefopam-Celecoxib combination shows its effectiveness in the early reduction of these CPRAOs, anxiety and length of stay with a high overall level of patient satisfaction. Given the good tolerance and accessibility of these products, we strongly suggest the use of this protocol for its validation in our environment and elsewhere, although it is desirable to continue research on other non-explored alien pathways.
选择性5 -羟色胺再摄取抑制剂和选择性环氧化酶-2抑制剂对脊髓麻醉后头痛的协同作用
目的:评价选择性5 -羟色胺再摄取抑制剂(SSRI)和选择性环氧化酶2抑制剂(ISCOx-2)在产科护理中治疗腰麻后头痛的协同作用。患者和方法:这是一项为期12个月的实验性双盲、随机、多中心临床试验(2018年5月1日至2019年4月30日),在刚果民主共和国东南部的六家医院进行的非劣效性临床试验,包括所有因产科指征而接受脊髓麻醉手术或镇痛的患者,并伴有硬脑膜角化的头痛特征,无已知原因,实验产品的禁忌症,并获得知情同意。根据治疗方案将患者分为4组,即:A组=补液+扑热息痛,B组=补液+塞来昔布,C组=补液+奈福泮,4组=补液+塞来昔布+奈福泮(研究组)。使用Statview II软件,对不同检验获得的数据进行统计分析,采用方差分析检验,比较不同样本的平均值,采用Fisher检验。通过峰度和偏度的平坦化和不对称检验来验证样品的正态性。结果:将塞来昔布和奈福泮联合使用的方案显着表明其在头两天减少CPRAOs的有效性,并逐渐减少焦虑和住院时间。此外,大多数患者(75.6%)对该方案总体满意度较高。结论:奈福泮-塞来昔布联合用药在早期降低患者CPRAOs、焦虑和住院时间方面具有较好的效果,患者总体满意度较高。鉴于这些产品的良好耐受性和可及性,我们强烈建议在我们的环境和其他地方使用该协议进行验证,尽管希望继续研究其他未探索的外星途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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