Stojanović Marina, Marinković Milana, Miličić Biljana, Stojičić Milan, Jović Marko, Jovanović Milan, Isaković Subotić Jelena, Jurišić Milana, Karamarković Miodrag, Đekić Aleksandra, Radenović Kristina, Mihaljević Jovan, Radosavljević Ivan, Suđecki Branko, Savić Milan, Kostić Marko, Garabinović Željko, Jeremić Jelena
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
J Clin Med. 2024 Jan 29;13(3):764. doi: 10.3390/jcm13030764.
: Burn wound dressing and debridement are excruciatingly painful procedures that call for appropriate analgesia-typically multimodal. Better post-procedural pain management, less opioid use, and consequently fewer side effects, which could prolong recovery and increase morbidity, are all benefits of this type of analgesia. Intravenously administered ketamine can be effective as monotherapy or in combination with opioids, especially with procedural sedation such as in burn wound dressing. : This observational study investigated the effect of ketamine administered in subanesthetic doses combined with opioids during burn wound dressing. The study was conducted from October 2018 to October 2021. A total of 165 patients met the inclusion criteria. A total of 82 patients were in the ketamine group, while 83 patients were dressed without ketamine. The main outcome was the effect of ketamine on intraprocedural opioid consumption. The secondary outcome included the effect of ketamine on postprocedural pain control. : Patients dressed with ketamine were significantly older ( = 0.001), while the mean doses of intraoperatively administered propofol and fentanyl were significantly lower than in patients dressed without ketamine (150 vs. 220 mg, < 0.001; and 0.075 vs. 0.150 mg, < 0.001; respectively). : Ketamine was an independent predictor of lower intraoperative fentanyl consumption, according to the multivariate regression analysis ( = 0.015). Contrarily, both groups of patients required postoperative tramadol treatment, while intraoperative ketamine administration had no beneficial effects on postoperative pain management.
烧伤创面换药和清创是极其痛苦的操作，需要适当的镇痛——通常采用多模式镇痛。这种类型的镇痛具有诸多益处，包括更好的术后疼痛管理、更少的阿片类药物使用，以及随之减少的副作用，而这些副作用可能会延长康复时间并增加发病率。静脉注射氯胺酮作为单一疗法或与阿片类药物联合使用可能有效，尤其是在烧伤创面换药等操作镇静过程中。：这项观察性研究调查了在烧伤创面换药期间，亚麻醉剂量的氯胺酮与阿片类药物联合使用的效果。该研究于2018年10月至2021年10月进行。共有165名患者符合纳入标准。氯胺酮组共有82名患者，而83名患者在换药时未使用氯胺酮。主要结局是氯胺酮对术中阿片类药物消耗量的影响。次要结局包括氯胺酮对术后疼痛控制的影响。：使用氯胺酮换药的患者年龄显著更大（P = 0.001），而术中丙泊酚和芬太尼的平均剂量显著低于未使用氯胺酮换药的患者（分别为150 vs. 220 mg，P < 0.001；以及0.075 vs. 0.150 mg，P < 0.001）。：根据多因素回归分析，氯胺酮是术中芬太尼消耗量较低的独立预测因素（P = 0.015）。相反，两组患者术后均需要曲马多治疗，而术中给予氯胺酮对术后疼痛管理没有有益影响。
