MULTIMODAL POSTOPERATIVE ANALGESIA: COMBINATIONS OF ANALGESICS AFTER ABDOMINAL SURGERY AT CHU- JRA ANTANANARIVO

Introduction :Intense to severe postoperative pain persists despite routine postoperative analgesia. The objective of the study was to determine a type of analgesic combination proposed in the multimodal technique to properly manage postoperative pain after abdominal surgery by laparotomy. Method : A single-center prospective observational study over a period of six months was conducted. Pain scores during the first six hours were assessed during the patients follow-up period. Comparison and correlation tests were used for data analysis (XLSTAT ® v18). Results : The study included 40 patients, aged 46 [18- 71] years, predominatlydemale (68%). Twelve types of surgical intervention were fond for an average duration of 127 [60- 300] minutes. Seven analgesic molecular combinations were used, always including paracetamol. Moderate to severe pain appeared from the second postoperative hour for patients receiving Association 7 while postoperative analgesia lasted until the sixth postoperative hour for those receiving Association 1 . No patient treated by Association 1, 3 and 4 expressed a need for morphine. This demand was high among those under Association 7 . Conclusion : The number and type of analgesics that made up the combination did not have much influence on postoperative pain. The synergism of action of analgesic combinations determines their effect on reducing the postoperative pain thershold for a given surgical procedure of the same type.