The effect of preemptive ketamine on postoperative analgesia in lower extremity surgery

Abstract

Background/Aim: Preventing sensitization by an analgesic administered before a painful stimulus is the basis for preemptive analgesia. Preemptive use of pain medication prior to the application of painful stimuli results in better-controlled pain. This study aimed to compare the effects of preoperatively administered low-dose ketamine and lornoxicam on postoperative analgesia, their side effects and patient satisfaction in orthopedic operations on the lower extremities. Methods: Seventy-eight patients aged 18-70 years who were admitted for lower extremity surgery under general anesthesia were enrolled in this prospective, randomized, and double-blind study. The patients were randomly allocated to one of the three following groups: Four milliliters of physiological saline were administered to the patients in Group P, 0.15 mg kg-1 ketamine was given to the patients in Group K and 8 mg lornoxicam was administered to those in Group L, all in 4 ml of volume, intravenously, 15 minutes before anesthesia induction. Postoperative pain was evaluated at rest and during movement at 0th, 2nd, 4th, 6th, 8th, 12th, 20th and 24th postoperative hours with the Visual Analogue Scale (VAS) and the Verbal Pain Scale (VPS). Total fentanyl consumption, additional meperidine usage, side effects and patient satisfaction were recorded at these times. Results: The mean area under the VAS and VPS at rest and movement-time curves were lower in Group K compared to the other groups. Group P and Group L were comparable in terms of the area under the VAS at rest and movement-time curves, but the mean area under the VPS at rest and movement-time curves were higher in Group P compared to Group L. Total fentanyl consumption was lower in Group K than the other two groups (P=0.001). Conclusion: Low-dose ketamine administered preoperatively to patients for lower extremity surgery decreased postoperative pain scores more than lornoxicam or placebo.

Keywords

• Ketamine
• Preemptive analgesia
• Lornoxicam
• Lower extremity orthopedic surgery

Kaynakça

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