Assessment of the Effect of Ketamine in Combination with Remifentanil on Postoperative Pain

Assessment of the Effect of Ketamine in Combination with Remifentanil on Postoperative Pain

Author Leal, Plinio Cunha Autor UNIFESP Google Scholar
Sakata, Rioko Kimiko Autor UNIFESP Google Scholar
Salomao, Reinaldo Autor UNIFESP Google Scholar
Sadatsune, Eduardo Jun Autor UNIFESP Google Scholar
Issy, Adriana Machado Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
TSA
Abstract Background and objectives: the combination of ketamine and remifentanil seems to be associated with better analgesia and duration. the aim of this study was to evaluate whether a ketamine-remifentanil combination promotes improved postoperative analgesia.Methods: Prospective, randomized, double blind study of 40 patients undergoing video laparoscopic cholecystectomy. Anesthesia was performed with remifentanil, propofol, atracurium, and 50% oxygen. Group 1 (G1) patients received remifentanil (0.4 mcg.kg(-1).min(-1)) and ketamine (5 mcg.kg(-1).min(-1)) and Group 2 (G2) received remifentanil (0.4 mcg.kg(-1).min(-1)) and saline solution. Morphine 0.1 mg.kg(-1) was administered at the end of the procedure, and postoperative pain was treated with morphine via PCA. We evaluated the severity of postoperative pain by a numerical scale from zero to 10 during 24 hours. We registered the time to the first analgesic supplementation, amount of morphine used in the first 24 hours, and adverse effects.Results: There was a decrease in pain severity between extubation and other times evaluated in G1 and G2. There was no significant difference in pain intensity between the groups. There was no difference between G1 (22 +/- 24.9 min) and G2 (21.5 +/- 28.1 min) regarding time to first dose of morphine and dose supplement of morphine consumed in G1 (29 +/- 18.4 mg) and G2 (25.1 +/- 13.3 mg).Conclusion: the combination of ketamine (5 mcg.kg(-1).min(-1)) and remifentanil (0.4 mcg.kg(-1).min(-1)) for cholecystectomy did not alter the severity of postoperative pain, time to first analgesic supplementation or dose of morphine in 24 hours. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
Keywords Analgesia
Postoperative Period
Ketamine
Cholecystectomy
Piperidines/remifentanil
Language English
Date 2013-03-01
Published in Revista Brasileira de Anestesiologia. New York: Elsevier B.V., v. 63, n. 2, p. 178-182, 2013.
ISSN 0034-7094 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 178-182
Origin http://dx.doi.org/10.1016/S0034-7094(13)70211-3
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000330124300003
SciELO ID S0034-70942013000200003 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/35998

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