Efficacy and tolerability of ketoprofen in patients with coronary artery disease in the postoperative period after cardiac surgery, depending on the comorbid status

Background. Patients with coronary artery disease (CAD) undergoing cardiac surgery often have a number of comorbidities. The simultaneous use of a large number of drugs can affect the efficacy and safety of drugs used for pain relief. Objective. Evaluation of the efficacy and tolerability of ketoprofen in CAD patients in the postoperative period after cardiac surgery, depending on the comorbid status. Methods. The study included 90 CAD patients in the early postoperative period. Cardiac surgery was performed according to the following indications: clinically significant coronary stenosis, valvular heart disease (stenosis and/or insufficiency of the aortic, mitral, tricuspid valves), aortic aneurysm. Postoperative analgesia was performed using ketoprofen 200 mg/day. The effectiveness of ketoprofen was evaluated by analyzing the intensity of postoperative pain syndrome. Ketoprofen tolerance was assessed by analyzing the incidence of acute renal injury, NSAID-associated dyspepsia, and hepatotoxic reactions in the postoperative period. The intensity of the pain syndrome was assessed using a digital rating scale. The Charlson index was used to quantify the comorbid status. Statistical analysis was performed using the Mann-Whitney test, Fisher’s exact test, and Pearson’sx2 test. Results. Moderate comorbidity was significantly more common in patients under 60 years of age compared to patients over 60 years of age: 19 (73%) and 9 (14%) patients (p<0.001), respectively. High comorbidity was noted in the older age group: 58 (90.6%) and 6 (23%) patients in the groups of 60 and over and under 60 years of age, respectively (p<0.001). There were no significant differences in the intensity of the pain syndrome depending on the degree of comorbidity. There were also no significant differences in adverse effects during anesthesia with ketoprofen, depending on the degree of comorbidity and the number of drugs taken simultaneously. Conclusion. Significant differences in the degree of comorbidity depending on the age group were revealed: moderate comorbidity was significantly more common in patients under the age of 60 years (P<0.001), high comorbidity - in patients over 60 years of age (P<0.001). There were no significant differences in the intensity of the pain syndrome and adverse effects during anesthesia with ketoprofen, depending on the degree of comorbidity.

comorbidity, postoperative pain relief, ketoprofen, efficacy, tolerability, adverse effects