630
PŮVODNÍ425200011151111173233294355388
PRÁCE839200011151111174230285
/1150200011132
ORIGINAL1208200011158118151213244306367421
PAPER1654200011151107163217278
Comparison4253200974690158204243270289321366412
of8533200974468
ibuprofen9383200971965110156183227251292338
and12923200973984130
paracetamol14393200974585112151188228255295362407427
combination18833200973679147193212257296323342387432
with23323200975979106151
ketorolac24993200973878105149176221241280316
and28323200973984130
paracetamol29793200974585111151187227255294362406426
in34223200971964
patients35033200974585112131172217243277
undergoing37963200974590136176203249293313358403
gynecologic42163200974584130171208251271316362381418
surgery46513200973176102148189216256
25015520001114289144
|343200011126
ANESTEZIOLOGIE4268040010753112155200245290342362425467527586607650
A10988040010753
INTENZIVNÍ1172804001071978123168227276296345405426
MEDICÍNA16198040010770114174195248268328382
/20468040010732
Anest21238040010753101145179208
intenziv235080400107196794137185222241282
Med.26528040010770114164180
2025;36(4):247-2522852804001074487128172185229273296338359374418458499522560604646
/35438040010732
www.aimjournal.cz48358040010765133201214257275349367415463490539579598614654693
postoperatively,425230001075099132161208258303329371398417458501521561572
the1014230001072876120
mean11512300010774118159207
CT1375230001075196
increased1488230001071967107134177217250294344
by1849230001075089
0.051955230001074460104147
in2119230001071967
Group2203230001075683130178228
124482300010744
and2509230001074189138
by2664230001075089
0.13277023000107445998135
in425244001071968
Group520244001075784132182232
2;779244001074560
however,866244001074999165209250294322334
this122724400107287796130
difference138424400107496993121166193236286327370
was17812440010766108142
not1951244001074898126
statistically2104244001073463106133153186216235276319338357398
significant2529244001073453103152171196216257299348376
(p425258001072475
>5262580010754
0.05).607258001074460104148171184
Regarding818258001074690141182209257276324374
changes1219258001074089130178228273307
in1552258001071968
BT,164625800107468899
at1772258001074168
241867258001074485
hours1978258001074998146173208
postoperatively,22122580010750100134163210261306333375402421463506526566578
BT2817258001074688
increased425272001071966106133175215248292341
by782272001075089
0.03887272001074459103144
in1048272001071866
Group1130272001075682129177226
113722720010744
and1432272001074188137
by1586272001074988
0.091690272001074459103147
in1853272001071967
Group1936272001075682129177226
2,2178272001074459
with2253272001076584111159
no2429272001074896
significant2541272001073351100147166189209249290337364
difference42528600107496892119162189232280321363
between808286001074994122190233278326
the1154286001072876120
groups1294286001074975122170220253
(p1567286001072474
>16612860010753
0.05).1734286001074459104147170183
However,5653000010757105170213254297324336
the919300001072876121
comparison1059300001074086160210252278297330378427
of1505300001074872
BT1596300001074587
changes1702300001074088129177226270304
between2025300001075095122190233278326
223703000010744
hours2433300001074897145171206
preoperatively2657300001075077120169219425314001074470111138157198241260300
and742314001074189138
48896314001074490
hours1002314001074897145171205
postoperatively1224314001074998132160207257302328370397415456499519558
showed1799314001073381129194237287
a21033140010741
significant2160314001073452101149167191211251292340367
difference254331400107496892119162189231280320362
between425328001075095122190233278326
Groups775328001075683130178228261
110603280010743
and1127328001074189138
212893280010744
(p1356328001072474
<14533280010754
0.05),1530328001074460104147170183
with1737328001076584112160
mean19213280010773118158206
increases2150328001071967107134177217250295328
of2502328001074771
0.052597328001074459104147
and2767328001074189138
0.24,425342001074358103143157
respectively.598342001072668101150194234264282323365384423435
No10493420010757104
significant1169342001073351100147165188208247288335361
difference154634200107496790117160186228275315357
was19193420010764105138
observed2072342001074897130173199243285334
in2422342001071966
BT2504342001074586
changes2606342001074087127174223266299
between425356001075095122190233278326
24771356001074484
and875356001074189138
481033356001074489
hours1142356001074897145171205
postoperatively1367356001075099132161208258303330371398417458501521561
in1947356001071967
either203435600107436290138183209
group2263356001074975122170220
(p2503356001072373
>25963560010754
0.05).2670356001074359103146169182
The565370001074291135
trends71737000107285497145195227
in961370001071966
CT1044370001075196
and1157370001074189138
BT1311370001074688
for141537000107247198
both1530370001074998126174
groups1720370001074975122170220253
are1990370001074067110
illustrated211637000107193856103136165192233260303352
in2485370001071967
Figures2569370001094464115164194239275
328603700010946
and425384001094393145
4.58638400109466313840010716
CT663384001075297
remained776384001072770143184203250295345
relatively113738400107277089129156175216259279319
stable1472384001073463104154173217
in1706384001071966
the1789384001072876120
ibuprofen1926384001071968116166193240264307355
group,2298384001074975122170220234
whereas25493840010764113157184226267300
a28653840010741
slight42539800107335169116163189
increase630398001071865104130171210243286
was9313980010764104137
observed1083398001074796128171197240282330
in1429398001071865
the1510398001072774117
ketorolac1642398001073880107152178224243282322
group.1979398001074874119166215229
BT2224398001074485
showed2325398001073379126190232281
minimal2621398001077391137155227266284
changes425412001074089129178227272305
in757412001071967
the850412001072877121
ibuprofen998412001071968117167194241265309357
group,1382412001074975123171221235
but1644412001075098126
increased1797412001071967108134178218251296346
more21704120010773122149193
notably2389412001074897125166216236276
in2691412001071967
the2785412001072876121
ketorolac425426001073881109156183230249290330
group,775426001074975122171220235
particularly1029426001075092118149168208256275315342361401
at1450426001074168
481537426001074490
hours1647426001074896144171205
postoperatively.1872426001074999132161208258303329371398417458501520560572
3.425451001386087
Interleukin-65334510013835100139193242273324387449484549582643
Levels11974510013861114167219251298
The425468001074394140
results593468001072771106155174203240
presented860468001075179124158204254282326378
in1265468001071969
Table1362468001094685138161208
515974680010947
indicate1671468001071969120139181224252296
no1995468001074999
significant2122468001073453104153173198219260303353381
difference253046800107507095123168196240290332376
in425482001071968
the519482001072978122
mean6684820010775120160209
IL-690448200107196079127
levels1057482001072064106150169202
at1286482001074269
213824820010744
hours1453482001074998147174209
preoperatively1689482001075077121171221267294336364383425469488529
between2245482001075096124192237282331
Group2603482001075784132181231
128614820010744
and425496001074189138
Group589496001075683130178228
28424960010744
(p911496001072474
>10104960010754
0.05),1089496001074459104147170183
indicating1297496001071967117135175217244263311360
comparable1682496001074187161211252279320370390434
baseline2141496001075091124169188206254298
IL-6246549600107195977124
levels2615496001071963103146166198
in2839496001071866
both425510001075099127175
groups.627510001074975122171221254271
However,9255100010756105170214255298325337
IL-6128851000107195978125
levels1440510001071963104147167199
differed166651000107496892119163190233283
significantly1975510001073452102150169193213253295343370389429
between2431510001075095123191234279328
the2785510001072876121
two425524001072896144
groups595524001075076124172222256
at877524001074169
69725240010744
hours1043524001074897145172207
and1276524001074189139
241442524001074484
hours1553524001074897145172206
postoperatively1786524001075099133162209260305332374401420461505524564
(p2377524001072474
<24785240010754
0.05).2558524001074460105148171184
The2769524001074292136
comparison425538001074188164214257284304337387436
of888538001074973
IL-698853800107206180128
levels1143538001071964106150170203
between1373538001075096125193238284333
the1733538001072877122
groups1882538001075077125174225259
over2168538001074990134161
the2356538001072878123
study2506538001073464113163204
time2737538001072848122168
points4255520010751102122172200237
is690552001071953
illustrated77155200107193959108143173201245273317369
in1168552001072069
Figure1266552001094567119171202249
3.1542552001094815885520010716
IL-6163255200107206181130
levels1790552001071965107152173207
increased2025552001071969111139184226260307359
from2411552001072554103179
226185520010746
hours26915520010750100151178214
preoperatively425566001075077120169219264290332359378419462481521
to966566001072875
610615660010744
hours1125566001074897145171205
postoperatively,1351566001074999132161208258303329371398417458501520560572
followed194356600107247191109158222266316
by2279566001075089
a23885660010741
decline2449566001074993135153172220264
at2733566001074168
242821566001074484
hours425580001074897145171205
postoperatively650580001075099133162208258303330371398417458501521561
in1230580001071967
both1317580001075099126174
groups.1511580001074975122171220254270
Discussion4256040015382122175233305358411451515587
This425622001074393113146
study598622001073464113164205
compares830622001074189164215258285329363
the1220622001072978123
analgesic1370622001074291133152203248282301343
efficacy,174062200107446997117158201242286298
effects206562200107446997141184215250
on2343622001074898
coagulation2468622001074189131182230250291319339388438
profiles,425636001075077125149169188233267283
and735636001074190140
inflammatory90163600107196891114155230304345373420447491
responses1418636001072770105154204253287331365
of1810636001074873
the1909636001072877122
ibuprofen-paracetamol2057636001071969118168196243268312360389440482509551592635663705779828848
combination425650001074085158207226273313339357404452
versus893650001074083109142188220
the1129650001072875118
ketorolac-paracetamol1263650001073880107153180226245285324347396437463504543585612653725773792
combination2071650001073985158207225272312339357404452
in2539650001071865
patients2620650001074990117135178225251285
undergoing304762001074794142186211258306324371419
gynecological348262001074888136179219265284331380398437478496
surgery.399462001073379104152195220262274
The428362001074290134
findings44326200107244389138156203251283
demonstrate473162001074891163211258290319345385412453
that520062001072774114141
both535662001074997124171
analgesic304776001074189130149198242276294334
combinations340276001074187161211230278319346365413461494
paracetamol-ibuprofen391676001075091118159200242270312385434453481501550599648675722746790838
and477576001074189139
paracetamol-ketorolac493576001075091118159200242270312385434453481520563304790001072875102149169210251
are331890001074167110
effective34559000107436795139180211230271314
in379690001071967
managing3889900010774115163204254273321371
postoperative428690001075099133162209259304331373400419461504
gynecological481690001075090140184225272292341391410450492511
pain,535390001075092111159175
with3047104001076584112161
no3232104001074897
significant3353104001073452101149168192211252293341368
differences374510400107496892119163189232280321363397
observed4167104001074898131175202246289339
in4531104001071866
NRS46221040010757103145
scores.4792104001073374121148190224241
These5057104001074292136170214
results5295104001072770104151170197232
are3047118001074167110
consistent3174118001074087135168186219248291339366
with3556118001076585113161
prior373411800107497695143170
research3921118001072770103147188214253301
by4239118001074989
Rahim4344118001074687135154227
et4588118001074471
al.467611800107416076
(2023)4768118001072467110151195216
which50011180010765114132173221
similarly5238118001073452125144163203230249289
reported3047132001072770119168195226269319
no3389132001074896
significant3509132001073351100148167191211251292341367
differences389913200107496892119163189232280321363397
in4319132001071967
pain4409132001075091110158
levels4590132001071963103147166199
between4812132001074994122189233278326
the5161132001072876120
paracetamol-ibuprofen53041320010750911181592003047146001074471112186234254281301350399448475522546589637
and3700146001074189138
paracetamol-ketorolac3855146001074991117159199241269310384432451479518561589635662709729769809
combinations4681146001074086160210229277317344363411459492
following519014600107237190109157221240288337
functional3047160001072473121161191210258307348367
endoscopic3439160001074492141190223264310360380420
sinus3884160001073452100147180
surgery4090160001073380107155199225269
[11].438316000109266910612745091600010716
This4550160001074292110143
supports4718160001073481131181230257288323
the5066160001072876120
principle521216000107497696144184203252272316
of3047174001074873
multimodal31471740010774122142170189264313364405425
analgesia,3598174001074290132151201246280299340356
wherein39811740010766115160187230249298
drug4306174001074976125175
combinations4508174001074188163214233282323351370419468502
may50371740010774116155
produce5219174001075077125176224265309
synergistic3047188001073475124168194243261294323342382
effects344918800107436794138179209244
in3713188001071967
reducing3799188001072770120167208227274324
pain4143188001074991109157
and4320188001074189138
opioid4478188001074898117165184233
consumption.4731188001074087136169216289339366385433482498
Tab.425600012561110164190
4.63160001255481
Comparison75762001074891163208254280298327372418
of119262001074568
CT127662001074890
and138362001074591136
BT153662001074382
changes163462001073783128175220258289
between193962001074684111175213251297
groups225362001074570114160206236
Time4567600984264132175
Group15757600985383129175223
1181576009842
(n15878600982468
=167286009848
20)17368600984387110
Group21427600985383129175223
2238276009842
(n21548600982468
=223986009848
20)23038600984387110
p-value26047600984775115157178224266
Mean152998009866109150197
±174298009848
SD18079800984196
Mean209698009866109150197
±230998009848
SD23739800984297
Delta45611000985597119148190
CT66211000984792
(minutes)77011000982491112159205233275309332
2456122009539
hours51312200954286129153184
pre-2471412200954469107133168204
hours93612200954386129153184
post113712200954488119145
0.0015411220095395393134
±1692122009548
0.0017571220095405393134
0.0521151220095395393131
±2264122009548
0,1323291220095395388121
0.42926531220095395392129167
2456134009539
hours51313400954286129153184
pre-4871413400954469107133175216
hours94713400954386129153184
post114913400954488118144
0.0515481340095395393131
±1697134009548
0.1317621340095395388122
0.1321141340095395388121
±2253134009548
0.2223181340095395394133
0.26526521340095395394132170
2445614600953975
hours54914600954286129153184
post-4875014600954488118145167208249
hours101614600954387130154184
post121814600954488118144
0.0515481460095395393131
±1697146009548
0.1317621460095395388122
0.0921151460095395393133
±2265146009548
0.1723301460095395388121
0.58326521460095395393132170
Delta45615800985597119148190
BT66215800984689
(minutes)76815800982490112158204233274309331
2456170009539
hours51317000954286129153184
pre-2471417000954469107133168204
hours93617000954386129153184
post113717000954488119145
0.0315501700095395393130
±1698170009547
0.1117631700095395388119
0.0921111700095395393133
±2261170009548
0.2123261700095395394130
0.20126531700095395394132168
2456182009539
hours51318200954286129153184
pre-4871418200954469107133175216
hours94718200954386129153184
post114918200954488118144
0.0515481820095395393131
±1697182009548
0.1517621820095395388122
0.2421121820095395394130
±2259182009548
0.2423251820095395393129
0.02126541820095395393130165
2445619400953975
hours54919400954286129153184
post-4875019400954488118145167208249
hours101619400954387130154184
post121819400954488118144
0.0315481940095395393130
±1696194009547
0.1617611940095395388123
0.1421141940095395388123
±2254194009548
0.2923201940095395393132
0.15726571940095395388122159
Mann-Whitney456206009560101142184208273314331354395430463
test,9332060095245785108123
p1070206009540
value11252060095337389130164
<1304206009547
0.0513662060095375289125
is150520600951643
significant15622060095284484125142162179213252294316
Tab.4256770012561110164190
5.631677001255479
Comparison755678001074891163208254280298327372418
of1190678001074568
IL-6127467800107195675119
levels141067800107185695132150179
between1606678001074584110174212250297
groups1919678001074571115161206236
Time45669200984264132175
IL-617876920098216286132
(pg/mL)193669200982471118146213253277
p-value260469200984775115157178224266
Group157570400985383129175223
11815704009842
(n158771400982468
=1672714009848
20)173671400984387110
Group214270400985383129175223
22382704009842
(n215471400982468
=2239714009848
20)230371400984387110
Mean1529726009866109150197
±1742726009848
SD180772600984196
Mean2096726009866109150197
±2309726009848
SD237372600984297
2456738009539
hours51373800954286129153184
preoperatively71473800954469107151196236260297322339376415432468
28.9615237380095397792130170
±1711738009547
6.3017767380095395494133
27.7620997380095397683121158
±2274738009548
5.4723397380095395391128
0.52226517380095405494131170
6456750009539
hours51375000954286129153184
post-surgery71475000954488118145167197239263306346370408
46.5515267500095398095135171
±1715750009548
7.4617807500095394685126
57.0920787500095397783123163
±2258750009548
12.7223237500095397387126165
0.00326517500095395392133171
2445676200953975
hours54976200954286129153184
post-surgery75076200954488118145167197239263306346370408
35.2615277620095397690130168
±1713762009548
5.9717787620095395290127
42.3920937620095397690130168
±2278762009548
9.4023437620095395190131
0.00726527620095395393134170
Mann-Whitney456774009560101142184208273314331354395430463
test,9337740095245785108123
p1070774009540
value11257740095337389130164
<1304774009547
0.0513667740095375289125
is150577400951643
significant.15627740095284484125142162179213252294316330
Fig.3047214001255687137164
1.3227214001255478
CT3350216001074891
graph3457216001074571113159205
in3679216001071864
both3759216001074691117163
groups3938216001074671115161207237
23562376007229
hours36043760072336699117141
preoperative34943820072335281115149180198227246259287317
24411837600722957
hours41883760072326598117140
post-surgery40683820072336790110127150183201234264283312
48468737600722960
hours47613760072326598116140
post-surgery46383820072336790110127150183201234264283312
Fig.3047410001255687137164
2.3227410001255481
BT3353412001074382
graph3451412001074671114159206
in3673412001071965
both3754412001074591117163
groups3933412001074571115161206236
23562572007229
hours36045720072336699117141
preoperative34945780072335281115149180198227246259287317
24411857200722957
hours41885720072326598117140
post-surgery40685780072336790110127150183201234264283312
48468757200722960
hours47615720072326598116140
post-surgery46385780072336790110127150183201234264283312
Fig.3047606001255687137164
3.3227606001255479
IL-6335160800107195675119
levels348760800107185695132150180
in3683608001071864
both3764608001074591117162
groups3943608001074571114160206236
23562768007229
hours36047680072336699117141
preoperative34947740072335281115149180198227246259287317
24411876800722957
hours41887680072326598117140
post-surgery40687740072336790110127150183201234264283312
48468776800722960
hours47617680072326598116140
post-surgery46387740072336790110127150183201234264283312