Eftekhar Negar, Eslami Babak, Orandi Amir Hossein, Chabouk Leila, Ghotbizadeh Vahdani Fahimeh, Mohammad Khani Hoda, Amoozadeh Laya
Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran.
Anesthesiol Res Pract. 2023 Nov 4;2023:7782847. doi: 10.1155/2023/7782847. eCollection 2023.
Pain control after operations is essential in decreasing the patient recovery period and potential morbidity. Prescribing opiates is very effective, but significant side effects accompany them. This study aims to examine the effect of local ketamine infiltration in decreasing pain intensity in patients undergoing transabdominal hysterectomy.
In this double-blind, randomized, controlled clinical trial, a total of 92 patients undergoing transabdominal hysterectomy aged 30-60 years were selected and divided into two intervention and control groups randomly. For the intervention group, ketamine was injected subcutaneously into the incision site at a dose of 0.5 mg/kg after the operation. In the control group, 5 mg normal saline was used in the same method. Postoperative pain intensity was measured using the visual analog scale (VAS: 0-10). The pain score and dose of administered opioids were documented at 1, 2, 4, 6, 12, and 24 hours and compared between the two groups.
Postoperative pain intensity was significantly lower in the intervention group than in the control group, except for hour 24. The mean amounts of administered opioids were significantly lower in the intervention group at hours 6 and 12, as well as the total amount of used opioids, and no significant side effects were documented.
Local ketamine subcutaneous injection in the incisional site is effective and is a safe procedure for reducing pain scores in patients who underwent a transabdominal hysterectomy.
术后疼痛控制对于缩短患者恢复期及降低潜在发病率至关重要。开具阿片类药物止痛效果显著，但会伴随明显副作用。本研究旨在探讨局部注射氯胺酮对降低经腹子宫切除患者疼痛强度的影响。
在这项双盲、随机、对照临床试验中，共选取92例年龄在30至60岁之间接受经腹子宫切除术的患者，并随机分为两个干预组和对照组。干预组患者在术后于切口部位皮下注射0.5mg/kg氯胺酮。对照组则采用同样方法注射5mg生理盐水。使用视觉模拟评分法（VAS：0至10）测量术后疼痛强度。在术后1、2、4、6、12和24小时记录疼痛评分及阿片类药物给药剂量，并在两组间进行比较。
除24小时外，干预组术后疼痛强度显著低于对照组。干预组在术后6小时和12小时的阿片类药物平均给药量以及阿片类药物总用量均显著低于对照组，且未记录到明显副作用。
在切口部位局部皮下注射氯胺酮对于降低经腹子宫切除患者的疼痛评分是有效且安全的。
