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首页> 外文期刊>Journal of Armed Forces Medical College, Bangladesh >Preemptive Use of Low Dose Intravenous Ketamine on Post Operative Pain after Laparoscopic Cholecystectomy
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Preemptive Use of Low Dose Intravenous Ketamine on Post Operative Pain after Laparoscopic Cholecystectomy

机译：腹腔镜胆囊切除术后优先使用小剂量静脉注射氯胺酮治疗术后疼痛

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Introduction: There is a widespread belief for the efficacy of preemptive analgesia among clinicians. Different drugs and methods are used as preemptive analgesic method for postoperative pain management. Objective: To evaluate the efficacy of preemptive use of small dose intravenous ketamine on post operative pain on patients undergoing laparoscopic cholecystectomy. Materials and Methods: Sixty patients of both sexes as per American Society of Anaesthesiologists (ASA) physical status I and II underwent laparoscopic cholecystectomy were randomly allocated into two groups. In the operating room, Group A (n=30) received 0.5 mg/kg body weight of ketamine intravenously 10 minutes before the surgical incision. In Group B (n=30) 0.5 mg/kg body weight of normal saline was injected. Post operative analgesia was maintained with on demand intramuscular pethidine 1.5 mg/kg body weight. The pain intensity was assessed at time 0 (immediately after arousal) and 6, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). Side effects like nausea, vomiting, delirium and hallucination were also recorded. Results: For all of the evaluated times, the VAS score were significantly lower in Group A with ketamine compared to Group B with normal saline. The interval time for the first analgesic request was 22.9±6.8 (Mean±SD) minutes in Group A and 17.8±7.2 (Mean±SD) minutes in Group B and the difference was statistically significant (P=0.021). The total number of pethidine injections in first 24 hours postoperatively was 0.7±0.6 (Mean±SD) in Group A and 1.9±0.7 (Mean±SD) in Group B and the difference was statistically significant (P=0.037). The mean total cumulative amount of pethidine administered over 24 hrs period following the end of surgery in group A was 97.31±10.12 mg (Mean±SD) and in group B was 151.23±12.02 mg (Mean±SD) and the difference was statistically significant (P=0.008). Conclusion: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after laparoscopic cholecystectomy.
机译：简介：临床医生普遍认为先行镇痛的疗效。不同的药物和方法被用作抢先的镇痛方法，用于术后疼痛的治疗。目的：评估先行小剂量静脉注射氯胺酮对腹腔镜胆囊切除术患者术后疼痛的疗效。材料和方法：根据美国麻醉医师学会（ASA）I和II身体状况的60例男女患者，分别将其进行腹腔镜胆囊切除术分为两组。在手术室中，A组（n = 30）在手术切口前10分钟静脉注射氯胺酮0.5 mg / kg体重。在B组（n ＝ 30）中，注射0.5mg / kg体重的生理盐水。术后镇痛应按需使用1.5 mg / kg体重的肌内哌替啶。使用10点视觉模拟量表（VAS）在术后0时（唤醒后立即）和术后6、12和24小时评估疼痛强度。还记录了恶心，呕吐，ir妄和幻觉等副作用。结果：在所有评估时间中，氯胺酮A组的VAS评分明显低于生理盐水B组。 A组首次镇痛的间隔时间为22.9±6.8（Mean±SD）分钟，B组为17.8±7.2（Mean±SD）分钟，差异具有统计学意义（P = 0.021）。术后头24小时哌替丁注射的总数在A组为0.7±0.6（Mean±SD），在B组为1.9±0.7（Mean±SD），差异具有统计学意义（P = 0.037）。手术结束后24小时内，哌替啶的平均总累积量为97.31±10.12 mg（平均值±标准差），而B组为151.23±12.02 mg（平均值±标准差），差异有统计学意义（P = 0.008）。结论：小剂量静脉注射氯胺酮可减轻腹腔镜胆囊切除术后的疼痛。

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