PL EN


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
Czasopismo
2014 | 10 | 1 |
Tytuł artykułu

Ketamine in outpatient arthroscopic shoulder surgery: Effects on postoperative pain, hemodynamic stability and process times

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Background: Pain after arthroscopic shoulder surgery is often severe, and establishing a pain treatment regimen that does not delay discharge can be challenging. The reported ability of ketamine to prevent opioid-induced hyperalgesia has not been investigated in this particular setting. Methods: 300 adult patients scheduled for shoulder arthroscopy under general anesthesia were recruited for this observational clinical trial and were allotted to either receive 1mg/kg IV bolus of ketamine before surgery (ketamine group, KG) or to a control group (CG) without ketamine. NRS pain scores were obtained on the operative day and on postoperative days 1 and 2 and compared between groups. Secondary variables were blood pressure, heart rate, process times, satisfaction with the anesthetic and unwanted effects. Results: Pain severity did not differ significantly between the groups at any time. Propofol injection rate and cumulative dose were higher in the KG. Heart rates and blood pressures were similar. Time to emergence and time in PACU were longer and vomiting was more frequent in patients given ketamine. Conclusion: Preoperative low-dose ketamine added to a general anesthetic does not reduce perioperative pain after outpatient shoulder arthroscopy. It increases procedural times and the incidence of PONV.
Wydawca

Czasopismo
Rocznik
Tom
10
Numer
1
Opis fizyczny
Daty
otrzymano
2015-02-26
zaakceptowano
2015-05-18
online
2015-05-28
Twórcy
  • Department of Anaesthesiology, Emergency and
    Intensive Care Medicine, University of Göttingen Medical School,
    Göttingen, Germany
  • Department of Anesthesiology
    and Intensive Care Medicine, University Hospital Schleswig-Holstein,
    Campus Kiel, Kiel, Germany
autor
  • Department of Anesthesiology
    and Intensive Care Medicine, University Hospital Schleswig-Holstein,
    Campus Kiel, Kiel, Germany
autor
  • Department of Anaesthesiology, Emergency and
    Intensive Care Medicine, University of Göttingen Medical School,
    Göttingen, Germany
  • Department of Anaesthesiology, Emergency and
    Intensive Care Medicine, University of Göttingen Medical School,
    Göttingen, Germany
  • Clinic for Anesthesiology, University Hospital
    Regensburg, Germany
  • Department of Anaesthesiology, Emergency and
    Intensive Care Medicine, University of Göttingen Medical School,
    Göttingen, Germany
  • Department of Anaesthesiology, Emergency and
    Intensive Care Medicine, University of Göttingen Medical School,
    Göttingen, Germany
  • Center for Anesthesiology,
    Emergency and Intensive Care Medicine, University Hospital Göttingen,
    Robert-Koch Str. 40, 37075 Göttingen, Germany
Bibliografia
  • [1] Rawal N., Postdischarge complications and rehabilitationafter ambulatory surgery. Curr. Opin. Anaesthesiol., 2008, 21,736-742
  • [2] Angst M.S., Clark J.D., Opioid-induced hyperalgesia: Aqualitative systematic review. Anesthesiology, 2006, 104,570-587
  • [3] Chu L.F., Angst M.S., Clark D., Opioid-induced hyperalgesia inhumans: Molecular mechanisms and clinical considerations.Clin. J. Pain, 2008, 24, 479-496[WoS]
  • [4] Koppert W., Schmelz M., The impact of opioid-inducedhyperalgesia for postoperative pain. Best Pract. Res. Clin.Anaesthesiol., 2007, 21, 65-83
  • [5] Kohrs R., Durieux M.E., Ketamine: Teaching an old drug newtricks. Anesth. Analg., 1998, 87, 1186-1193
  • [6] Menigaux C., Guignard B., Fletcher D., Sessler D.I., DupontX., Chauvin M., Intraoperative small-dose ketamine enhancesanalgesia after outpatient knee arthroscopy. Anesth. Analg.,2001, 93, 606-612
  • [7] Ozyalcin N.S., Yucel A., Camlica H., Dereli N., AndersenO.K., Arendt-Nielsen L., Effect of pre-emptive ketamine onsensory changes and postoperative pain after thoracotomy:Comparison of epidural and intramuscular routes. Br. J.Anaesth., 2004, 93, 356-361
  • [8] Sen H., Sizlan A., Yanarates O., Emirkadi H., Ozkan S., Dagli Get al., Comparison of gabapentin and ketamine in acute andchronic pain after hysterectomy. Anesth. Analg., 2009, 109,1645-1650[WoS]
  • [9] Lehmann K.A., Klaschik M., Lack of pre-emptive analgesiceffect of low-dose ketamine in postoperative patients. Aprospective, randomised double-blind study. Schmerz, 2001,15, 248-253
  • [10] Van Elstraete A.C., Lebrun T., Sandefo I., Polin B., Ketaminedoes not decrease postoperative pain after remifentanil-basedanaesthesia for tonsillectomy in adults. Acta Anaesthesiol.Scand., 2004, 48, 756-760
  • [11] Lux E.A., Haack T., Hinrichs K., Mathejka E., Wilhelm W.,Ketamine racemate and fast track anaesthesia. Influence onrecovery times and postoperative opioid needs. Anaesthesist,2009, 58, 1027-1034
  • [12] Reza F.M., Zahra F., Esmaeel F., Hossein A., Preemptiveanalgesic effect of ketamine in patients undergoing electivecesarean section. Clin. J. Pain, 2010, 26, 223-226[WoS]
  • [13] Jeong H., Jeong S., Lim H.J., Lee J., Yoo K.Y., Cerebral oxygensaturation measured by near-infrared spectroscopy and jugularvenous bulb oxygen saturation during arthroscopic shouldersurgery in beach chair position under sevoflurane-nitrous oxideor propofol-remifentanil anesthesia. Anesthesiology, 2012, 116,1047-1056[WoS]
  • [14] Lee J.H., Min K.T., Chun Y.M., Kim E.J., Choi S.H., Effects ofbeach-chair position and induced hypotension on cerebraloxygen saturation in patients undergoing arthroscopicshoulder surgery. Arthroscopy, 2011, 27, 889-894[WoS]
  • [15] Yadeau J.T., Liu S.S., Bang H., Shaw P.M., Wilfred S.E., Shetty T.et al., Cerebral oximetry desaturation during shoulder surgeryperformed in a sitting position under regional anesthesia. Can.J. Anaesth., 2011, 58, 986-992
  • [16] Tweed W.A., Minuck M., Mymin D., Circulatory responses toketamine anesthesia. Anesthesiology, 1972, 37, 613-619
  • [17] Koppert W., Sittl R., Scheuber K., Alsheimer M., Schmelz M.,Schuttler J., Differential modulation of remifentanil-inducedanalgesia and postinfusion hyperalgesia by S-ketamine andclonidine in humans. Anesthesiology, 2003, 99, 152-159
  • [18] Komatsu R., Turan A.M., Orhan-Sungur M., McGuire J., RadkeO.C., Apfel C.C., Remifentanil for general anaesthesia: Asystematic review. Anaesthesia, 2007, 62, 1266-1280[WoS]
  • [19] Drdla R., Gassner M., Gingl E., Sandkuhler J., Induction ofsynaptic long-term potentiation after opioid withdrawal.Science, 2009, 325, 207-210[WoS]
  • [20] Van Elstraete A.C., Lebrun T., Sandefo I., Polin B., Arepreemptive analgesic effects of ketamine linked to inadequateperioperative analgesia? Anesth. Analg., 2004, 99, 1576
  • [21] Oliveira C.M., Sakata R.K., Issy A.M., Garcia J.B., Ketamineand preemptive analgesia. Rev. Bras. Anestesiol., 2004, 54,739-752
  • [22] Timm C., Linstedt U., Weiss T., Zenz M., Maier C., Sympathomimeticeffects of low-dose S-(+)-ketamine. Effect of propofoldosage. Anaesthesist, 2008, 57, 338-346[WoS]
  • [23] Sengupta S., Ghosh S., Rudra A., Kumar P., Maitra G., Das T.,Effect of ketamine on bispectral index during propofol--fentanylanesthesia: A randomized controlled study. Middle East J.Anesthesiol., 2011, 21, 391-395
  • [24] Haas D.A., Harper D.G., Ketamine, A review of its pharmacologicproperties and use in ambulatory anesthesia. Anesth.Prog., 1992, 39, 61-68
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_med-2015-0043
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.