Ketamina preemptiva en dosis bajas no afectan el consumo de anestesia, requerimientos de analgésicos postoperatorios, dolor postoperatorio, nausea o vomito en la cirugía dolorosa oftalmológica.
Preemptive low-dose of ketamine does not effective on anesthetic consumption, perioperative analgesic requirement and postoperative pain, nausea and vomiting in painful ophthalmic surgery.
Abdolahi M, Soltani HA, Montazeri K, Soleymani B.
J Res Med Sci. 2013 Jul;18(7):583-7.
Abstract
BACKGROUND: Ketamine, a non-competitive NMDA (N-Methyl-D-Aspartate) receptor antagonist, is recognized as an intraoperative anesthetic agent. Increasing interest in the use of low-dose ketamine for postoperative analgesia has developed in part because of its NMDA-antagonistic properties, which may be important in attenuating central sensitization and opioid tolerance. Despite of many trial evaluations which have been done on the effect of low-dose ketamine in postoperative pain, the role of ketamine, as a component of perioperative analgesia, remains unclear. We evaluated the analgesic effect of low-dose ketamine during anesthesia induction in painful ophthalmic surgery. MATERIALS AND METHODS: After institutional approval and written informed consent, 88 patients undergoing retinal detachment, strabismus, and keratoplasty surgery aged 18-80 years old were randomly divided intoequal case and control groups. Anesthesia was induced with sodium thiopental, fentanyl, atracurium, and liducaine, and maintained with N2O, O2, and propofol. Ketamine 0.5 mg/kg was administered intravenously to patients in the case group during anesthetic induction. Mean blood pressure and pulse rate were listed in questionnaire every 5 minutes. The consumption of anesthetic, perioperative additional analgesic, extubation time, postoperative pain and nausea scores (based on Visual Analog Scale), vomiting frequency, and the recovery time were recorded. RESULTS: There were no differences in the recovery time (17.3 ± 3.4 in the case group vs. 16.3 ± 3 in the control group, P < 0.05), postoperative pain scores (5 ± 1 in the case group vs. 5.6 ± 2 in the control group, P < 0.05), the consumption of anesthetic (9376.9 ± 1245.8 in the case group vs. 9012.9 ± 1620 in the control group, P < 0.05), the analgesic requirements (1000 in the case group vs. 940.9 ± 135.6 in the control group, P < 0.05), and perioperative additional analgesic (63.4 ± 26.5 in the case group vs. 69.4 ± 25.6 in the control group, P < 0.05) between two groups. The extubation time in the case group (13.59 ± 4.83) was significantly shorter than in the control group (15.9 ± 3.6) (P = 0.01). CONCLUSION: This study demonstrates that a low dose administration of ketamine during anesthesia induction in retinal detachment, strabismus, and keratoplasty surgery improves the extubation time but have no effect on postoperative pain, nausea and vomiting, and perioperative additional analgesic requirements.
KEYWORDS: Analgesic requirements, keratoplasty, low-dose ketamine, postoperative pain, retinal detachment, strabismus
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897026/
http://journals.mui.ac.ir/jrms/article/view/9305/3946
El acetaminofen i.v. es superior a la ketamina para dolor postoperatorio después de histerectomía abdominal. Resultados de un estudio prospectivo, randomizado, doble ciego y multicéntrico
Intravenous acetaminophen is superior to ketamine for postoperative pain after abdominal hysterectomy: results of a prospective, randomized, double-blind, multicenter clinical trial.
Faiz HR, Rahimzadeh P, Visnjevac O, Behzadi B, Ghodraty MR, Nader ND.
J Pain Res. 2014 Jan 17;7:65-70. doi: 10.2147/JPR.S53234. eCollection 2014.
Abstract
BACKGROUND:In recent years, intravenously (IV) administered acetaminophen has become one of the most common perioperative analgesics. Despite its now-routine use, IV acetaminophen's analgesic comparative efficacy has never been compared with that of ketamine, a decades-old analgesic familiar to obstetricians, gynecologists, and anesthesiologists alike. This doubleblind clinical trial aimed to evaluate the analgesic effects ofketamine and IV acetaminophen on postoperative pain after abdominal hysterectomy.METHODS:Eighty women aged 25-70 years old and meeting inclusion and exclusion criteria were randomly allocated into two groups of 40 to receive either IV acetaminophen or ketamine intraoperatively. Postoperatively, each patient had patient-controlled analgesia. Pain and sedation (Ramsay Sedation Scale) were documented based on the visual analog scale in the recovery room and at 4 hours, 6 hours, 12 hours, and 24 hours after the surgery. Hemodynamic changes, adverse medication effects, and the need for breakthrough meperidine were also recorded for both groups. Data were analyzed by repeated-measures analysis of variance. RESULTS:Visual analog scale scores were significantly lower in the IV acetaminophen group at each time point (P<0.05), and this group required significantly fewer doses of breakthrough analgesics compared with the ketamine group (P=0.039). The two groups had no significant differences in terms of adverse effects. CONCLUSION:Compared with ketamine, IV acetaminophen significantly improved postoperative pain after abdominal hysterectomy.
KEYWORDS: abdominal hysterectomy, analgesia, intravenous acetaminophen, ketamine, postoperative pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900330/pdf/jpr-7-065.pdf
Analgesia preemptiva con ketamina para colecistectomía laparoscópica
Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy.
Singh H, Kundra S, Singh RM, Grewal A, Kaul TK, Sood D.
J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):478-84. doi: 10.4103/0970-9185.119141.
Abstract
BACKGROUND: The aim of preemptive analgesia is to reduce central sensitization that arises from noxious inputs across the entire perioperativeperiod. N-methyl d-aspartate receptor antagonists have the potential for attenuating central sensitization and preventing central neuroplasticity. MATERIALS AND METHODS: Patients undergoing laparoscopic cholecystectomy were randomized into four groups of 20 patients each, who were administered the study drug intravenously 30 min before incision. Groups A, B, and C received ketamine in a dose of 1.00, 0.75 and 0.50 mg/kg, respectively, whereas group D received isotonic saline. Anesthetic and surgical techniques were standardized. Postoperatively, the degree of pain at rest, movement, and deep breathing using visual analogue scale, time of request for first analgesic, total opioid consumption, and postoperativenausea and vomiting were recorded in postanesthesia care unit for 24 h. RESULTS:Pain scores were highest in Group D at 0 h. Groups A, B, and C had significantly decreased postoperative pain scores at 0, 0.5, 3, 4, 5, 6, and 12 h. Postoperative analgesic consumption was significantly less in groups A, B, and C as compared with group D. There was no significant difference in the pain scores among groups A, B, and C. Group A had a significantly higher heart rate and blood pressure than groups B and C at 0 and 0.5 h along with 10% incidence of hallucinations. CONCLUSION:Preemptive ketamine has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. The lower dose of 0.5 mg/kg being devoid of any adverse effects and hemodynamic changes is an optimal dose for preemptive analgesia in patients undergoing laparoscopic cholecystectomy.
KEYWORDS: Ketamine, pain relief laparoscopic cholecystectomy, preemptive analgesia
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819841/
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=4;spage=478;epage=484;aulast=Singh;type=2
Atentamente
Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Preemptive low-dose of ketamine does not effective on anesthetic consumption, perioperative analgesic requirement and postoperative pain, nausea and vomiting in painful ophthalmic surgery.
Abdolahi M, Soltani HA, Montazeri K, Soleymani B.
J Res Med Sci. 2013 Jul;18(7):583-7.
Abstract
BACKGROUND: Ketamine, a non-competitive NMDA (N-Methyl-D-Aspartate) receptor antagonist, is recognized as an intraoperative anesthetic agent. Increasing interest in the use of low-dose ketamine for postoperative analgesia has developed in part because of its NMDA-antagonistic properties, which may be important in attenuating central sensitization and opioid tolerance. Despite of many trial evaluations which have been done on the effect of low-dose ketamine in postoperative pain, the role of ketamine, as a component of perioperative analgesia, remains unclear. We evaluated the analgesic effect of low-dose ketamine during anesthesia induction in painful ophthalmic surgery. MATERIALS AND METHODS: After institutional approval and written informed consent, 88 patients undergoing retinal detachment, strabismus, and keratoplasty surgery aged 18-80 years old were randomly divided intoequal case and control groups. Anesthesia was induced with sodium thiopental, fentanyl, atracurium, and liducaine, and maintained with N2O, O2, and propofol. Ketamine 0.5 mg/kg was administered intravenously to patients in the case group during anesthetic induction. Mean blood pressure and pulse rate were listed in questionnaire every 5 minutes. The consumption of anesthetic, perioperative additional analgesic, extubation time, postoperative pain and nausea scores (based on Visual Analog Scale), vomiting frequency, and the recovery time were recorded. RESULTS: There were no differences in the recovery time (17.3 ± 3.4 in the case group vs. 16.3 ± 3 in the control group, P < 0.05), postoperative pain scores (5 ± 1 in the case group vs. 5.6 ± 2 in the control group, P < 0.05), the consumption of anesthetic (9376.9 ± 1245.8 in the case group vs. 9012.9 ± 1620 in the control group, P < 0.05), the analgesic requirements (1000 in the case group vs. 940.9 ± 135.6 in the control group, P < 0.05), and perioperative additional analgesic (63.4 ± 26.5 in the case group vs. 69.4 ± 25.6 in the control group, P < 0.05) between two groups. The extubation time in the case group (13.59 ± 4.83) was significantly shorter than in the control group (15.9 ± 3.6) (P = 0.01). CONCLUSION: This study demonstrates that a low dose administration of ketamine during anesthesia induction in retinal detachment, strabismus, and keratoplasty surgery improves the extubation time but have no effect on postoperative pain, nausea and vomiting, and perioperative additional analgesic requirements.
KEYWORDS: Analgesic requirements, keratoplasty, low-dose ketamine, postoperative pain, retinal detachment, strabismus
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897026/
http://journals.mui.ac.ir/jrms/article/view/9305/3946
El acetaminofen i.v. es superior a la ketamina para dolor postoperatorio después de histerectomía abdominal. Resultados de un estudio prospectivo, randomizado, doble ciego y multicéntrico
Intravenous acetaminophen is superior to ketamine for postoperative pain after abdominal hysterectomy: results of a prospective, randomized, double-blind, multicenter clinical trial.
Faiz HR, Rahimzadeh P, Visnjevac O, Behzadi B, Ghodraty MR, Nader ND.
J Pain Res. 2014 Jan 17;7:65-70. doi: 10.2147/JPR.S53234. eCollection 2014.
Abstract
BACKGROUND:In recent years, intravenously (IV) administered acetaminophen has become one of the most common perioperative analgesics. Despite its now-routine use, IV acetaminophen's analgesic comparative efficacy has never been compared with that of ketamine, a decades-old analgesic familiar to obstetricians, gynecologists, and anesthesiologists alike. This doubleblind clinical trial aimed to evaluate the analgesic effects ofketamine and IV acetaminophen on postoperative pain after abdominal hysterectomy.METHODS:Eighty women aged 25-70 years old and meeting inclusion and exclusion criteria were randomly allocated into two groups of 40 to receive either IV acetaminophen or ketamine intraoperatively. Postoperatively, each patient had patient-controlled analgesia. Pain and sedation (Ramsay Sedation Scale) were documented based on the visual analog scale in the recovery room and at 4 hours, 6 hours, 12 hours, and 24 hours after the surgery. Hemodynamic changes, adverse medication effects, and the need for breakthrough meperidine were also recorded for both groups. Data were analyzed by repeated-measures analysis of variance. RESULTS:Visual analog scale scores were significantly lower in the IV acetaminophen group at each time point (P<0.05), and this group required significantly fewer doses of breakthrough analgesics compared with the ketamine group (P=0.039). The two groups had no significant differences in terms of adverse effects. CONCLUSION:Compared with ketamine, IV acetaminophen significantly improved postoperative pain after abdominal hysterectomy.
KEYWORDS: abdominal hysterectomy, analgesia, intravenous acetaminophen, ketamine, postoperative pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900330/pdf/jpr-7-065.pdf
Analgesia preemptiva con ketamina para colecistectomía laparoscópica
Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy.
Singh H, Kundra S, Singh RM, Grewal A, Kaul TK, Sood D.
J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):478-84. doi: 10.4103/0970-9185.119141.
Abstract
BACKGROUND: The aim of preemptive analgesia is to reduce central sensitization that arises from noxious inputs across the entire perioperativeperiod. N-methyl d-aspartate receptor antagonists have the potential for attenuating central sensitization and preventing central neuroplasticity. MATERIALS AND METHODS: Patients undergoing laparoscopic cholecystectomy were randomized into four groups of 20 patients each, who were administered the study drug intravenously 30 min before incision. Groups A, B, and C received ketamine in a dose of 1.00, 0.75 and 0.50 mg/kg, respectively, whereas group D received isotonic saline. Anesthetic and surgical techniques were standardized. Postoperatively, the degree of pain at rest, movement, and deep breathing using visual analogue scale, time of request for first analgesic, total opioid consumption, and postoperativenausea and vomiting were recorded in postanesthesia care unit for 24 h. RESULTS:Pain scores were highest in Group D at 0 h. Groups A, B, and C had significantly decreased postoperative pain scores at 0, 0.5, 3, 4, 5, 6, and 12 h. Postoperative analgesic consumption was significantly less in groups A, B, and C as compared with group D. There was no significant difference in the pain scores among groups A, B, and C. Group A had a significantly higher heart rate and blood pressure than groups B and C at 0 and 0.5 h along with 10% incidence of hallucinations. CONCLUSION:Preemptive ketamine has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. The lower dose of 0.5 mg/kg being devoid of any adverse effects and hemodynamic changes is an optimal dose for preemptive analgesia in patients undergoing laparoscopic cholecystectomy.
KEYWORDS: Ketamine, pain relief laparoscopic cholecystectomy, preemptive analgesia
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819841/
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=4;spage=478;epage=484;aulast=Singh;type=2
Atentamente
Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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