Preemptive Ketamine in Abdominal Hysterectomy Patients, Does the Route of Administration Affect Analgesia and Hemodynamics? A Prospective Randomized Controlled Trial
Aboelela, M. (2021). Preemptive Ketamine in Abdominal Hysterectomy Patients, Does the Route of Administration Affect Analgesia and Hemodynamics? A Prospective Randomized Controlled Trial. EKB Journal Management System, 83(1), 1429-1435. doi: 10.21608/ejhm.2021.168855
Mohamed Adel Aboelela. "Preemptive Ketamine in Abdominal Hysterectomy Patients, Does the Route of Administration Affect Analgesia and Hemodynamics? A Prospective Randomized Controlled Trial". EKB Journal Management System, 83, 1, 2021, 1429-1435. doi: 10.21608/ejhm.2021.168855
Aboelela, M. (2021). 'Preemptive Ketamine in Abdominal Hysterectomy Patients, Does the Route of Administration Affect Analgesia and Hemodynamics? A Prospective Randomized Controlled Trial', EKB Journal Management System, 83(1), pp. 1429-1435. doi: 10.21608/ejhm.2021.168855
Aboelela, M. Preemptive Ketamine in Abdominal Hysterectomy Patients, Does the Route of Administration Affect Analgesia and Hemodynamics? A Prospective Randomized Controlled Trial. EKB Journal Management System, 2021; 83(1): 1429-1435. doi: 10.21608/ejhm.2021.168855

Preemptive Ketamine in Abdominal Hysterectomy Patients, Does the Route of Administration Affect Analgesia and Hemodynamics? A Prospective Randomized Controlled Trial

The Egyptian Journal of Hospital Medicine
Article 96, Volume 83, Issue 1, April 2021, Page 1429-1435  XML PDF (582.38 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2021.168855
View on SCiNiTO View on SCiNiTO
Author
Mohamed Adel Aboelela email orcid
Department of Anesthesia and Surgical Intensive Care, Mansoura University, Egypt.
Abstract
Introduction: Hysterectomy is a common procedure and postoperative pain is a considerable problem. Preemptive analgesia includes analgesic administration prior to surgical stimulus. Ketamine is a short acting anesthetic drug with analgesic and anti-inflammatory properties, reducing central sensitization of pain pathway and hyperalgesia.
Objectives: This study aimed to assess the efficacy of preemptive use of ketamine as an analgesic drug, either by intravenous route or by subcutaneous infiltration at the incisional site, regarding perioperative hemodynamics, postoperative pain and gastrointestinal irritation symptoms.
Patients and methods: 60 patients were enrolled in this study, divided into two equal groups (30 each) according to route of preemptive ketamine administration. Group (V) received 0.5 mg.kg-1  intravenously while group (S) received 0.5 mg.kg-1 subcutaneously at incisional site. Postoperative pain assessment for 24 H. using visual analogue score (VAS) was adapted as primary outcome objective, while secondary outcomes included hemodynamic parameter and postoperative nausea and vomiting (PONV). Results: Data were analysed. VAS score showed significant difference among studied groups in early 2 postoperative hours. VAS0 (V 2.40±0.62, S 1.96±0.92, P 0.038), VAS1 (V 3.96±1.21, S 2.86±0.89, P 0.001), VAS2 (V 4.00±0.94, S 3.33±0.88, P 0.007). Also, first time to pethidine intake (V 1.50±0.93 H, S 2.36±1.27 H, P 0.004). Other study objectives were comparable.
Conclusion: Preemptive use of ketamine with subcutaneous infiltration at incisional site in total abdominal hysterectomy patients provided better analgesia in early postoperative hours rather than intravenous route with comparable hemodynamic parameter and side effects.
 
Keywords
Hemodynamics; Hysterectomy; Pain; Preemptive ketamine; VAS
Statistics
Article View: 239
PDF Download: 386