Unit:
Κατεύθυνση Αλγολογία: Αντιμετώπιση του πόνου, διάγνωση και θεραπεία. Φαρμακευτικές, παρεμβατικές και άλλες τεχνικέςLibrary of the School of Health Sciences
Supervisors info:
Παρασκευά Άντεια, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπουσα
Θεοδωράκη Κασσιανή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μπατιστάκη Χρυσάνθη, Εντεταλμένη Διδάσκουσα, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η επίδραση της διεγχειρητικής χορήγησης κεταμίνης στον μετεγχειρητικό πόνο μετά λαπαροσκοπική χολοκυστεκτομή
Translated title:
The effect of intraoperative ketamine administration on postoperative pain after laparoscopic cholecystectomy
Summary:
Introduction:Ketamine is a general anesthetic that has been used for its analgesic effect, when used at sub-anesthetic low doses, through its antagonistic action on NMDA receptors.
Purpose: The purpose of this work is to investigate whether the administration of ketamine after induction of anesthesia for laparoscopic cholecystectomy,reduces the postoperative consumption of tramadol and the intensity of postoperative pain.
Material-Method:In the clinical study, 60 patients who underwent laparoscopic cholecystectomy took part and were randomized into 2 groups, the control group and the ketamine group.For induction of anesthesia and intubation were administered intravenous fentanyl 2μg/Kg, propofol 2mg/Kg, rocuronium 0.9mg/Kg. After induction of anesthesia, the control group received 20 ml N/S 0.9% intravenous over a 20-minute period, while the ketamine group received intravenous ketamine 0.3 mg/Kg in an equal volume of normal saline. Intraoperatively, systolic and diastolic blood pressure, heart rate and hemoglobin saturation were recorded every 10 minutes. At the end of the surgery, all patients were given intravenous paracetamol 1 gr, tramadol 100 mg and dexketoprofen 50 mg. Immediately after entering the postoperative care unit, pain intensity was recorded using the NRS numerical scale (0-10) at rest and during movement (cough), as well as at 4, 8, and 24 hours postoperatively. If the postoperative pain had an intensity of NRS>5, tramadol 100 mg was administered intravenously with a maximum dose of 300 mg in 24 hours. The presence of shoulder pain upon awakening was also recorded. The primary endpoint of the study is total tramadol consumption in the 1st 24 hours postoperatively.
Results:Tramadol on demand was administered to 63% of participants in the Control Group while in the Ketamine Group it was administered to 18.5%. In the Control Group the mean value of tramadol administration is 203.70 mg, with a standard deviation of 93.98 while in the Ketamine Group it is 122.22 mg and 50.64 respectively with p<0.001. The two groups differed statistically significantly in pain intensity at rest (F=31.679, p<0.001) and in movement (F=23.487, p<0.001). The pain intensity in the Ketamine group is lower compared to the Control group at rest and movement.
Conclusions: The intravenous administration of ketamine at a dose of 0.3 mg/Kg reduced tramadol consumption the first 24 hours postoperatively and pain intensity at rest and in movement postoperatively.
Main subject category:
Health Sciences
Keywords:
Multimodal analgesia, Ketamine, Tramadol, Postoperative pain, Numerical rating scale
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Lykousi_Violeta_Msc.pdf
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