Department of Anesthesia, Cartagena University Hospital, Murcia, Spain.
Department of Anesthesia, Almansa General Hospital, Albacete, Spain.
Pain Res Manag. 2021 Nov 17;2021:3290289. doi: 10.1155/2021/3290289. eCollection 2021.
Acute postoperative pain (APP) has a high incidence in breast surgery, and opioids are the most commonly used drugs for its management; however, they are not free from systemic side effects, which may increase comorbidity. In the past few years, opioid-free anaesthesia has been favoured with promising results.
We conducted a descriptive study including 71 patients who underwent breast cancer surgery. The opioid group ( = 41) received fentanyl for induction, remifentanil for maintenance, and rescue morphine before waking up, whereas the ketamine group ( = 30) received a ketamine bolus for induction followed by continuous ketamine infusion during surgery. Later, the presence and intensity of pain were registered, using the Numeric Rating Scale (NRS 1-10) for pain, at different times in the recovery room, at 24 hours and at 3 months.
Administration of ketamine is more effective than opioid use for APP prevention in breast cancer surgery because the ketamine group presented with less pain than the opioid group ( < 0.05) at all measured times. When there was pain, patients in the ketamine group gave a lower score to its intensity ( < 0.05).
Ketamine could reduce the incidence of APP in breast cancer surgery, compared to opioids.
急性术后疼痛（APP）在乳房手术中发病率较高，阿片类药物是其管理中最常用的药物；然而，它们并非没有全身副作用，这可能会增加合并症。在过去的几年中，无阿片类麻醉得到了青睐，并取得了有希望的结果。
我们进行了一项描述性研究，纳入了 71 例接受乳腺癌手术的患者。阿片组（n=41）接受芬太尼诱导、瑞芬太尼维持，在苏醒前给予吗啡解救；而氯胺酮组（n=30）接受氯胺酮推注诱导，然后在手术期间持续输注氯胺酮。随后，在恢复室、24 小时和 3 个月的不同时间，使用数字评分量表（NRS 1-10）记录疼痛的存在和强度。
与阿片类药物相比，氯胺酮在预防乳腺癌手术 APP 方面更有效，因为氯胺酮组在所有测量时间的疼痛评分均低于阿片组（<0.05）。当有疼痛时，氯胺酮组的患者对其强度的评分较低（<0.05）。
与阿片类药物相比，氯胺酮可降低乳腺癌手术中 APP 的发生率。
