Ather Rana, Nikhar Sapna Annaji, Kar Akhay Kumar, Durga Padmaja, Prasanna Pindi Laxmi
Department of Anaesthesia and Intensive Care, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, Telangana, India.
J Anaesthesiol Clin Pharmacol. 2024 Oct-Dec;40(4):605-611. doi: 10.4103/joacp.joacp_67_23. Epub 2024 Apr 11.
Intravenous sedation during spinal anesthesia has the advantages of increased duration of spinal anesthesia and better postoperative pain control. The aim of this study was to compare the effect of intravenous bolus and infusion of dexmedetomidine versus ketamine given intraoperative on the postoperative analgesia in fracture femur patients operated under subarachnoid block.
In this prospective randomized double-blind controlled study, 75 patients aged 18-65 years posted for elective surgery were selected and randomly divided into three groups to receive ketamine (group K), dexmedetomidine (group D), and saline (control group C). Postoperative pain was evaluated using the numerical rating scale (NRS). The duration of analgesia and the amount of analgesic consumption were also recorded. Student's -test and Chi-square test were used to compare the two groups, and one-way ANOVA with posthoc analysis was performed for comparison of the three groups.
Patients in the ketamine group had better postoperative analgesia as assessed by decreased pain (on the NRS scale) and decreased need for postoperative rescue analgesics ( < 0.001). The duration of sensory block and motor block was prolonged in group K as compared to the other two groups ( < 0.001).
Intraoperative use of intravenous ketamine was superior to dexmedetomidine for postoperative analgesia in fracture femur patients operated under subarachnoid block.
脊髓麻醉期间静脉镇静具有延长脊髓麻醉持续时间和更好地控制术后疼痛的优点。本研究的目的是比较在蛛网膜下腔阻滞下行股骨骨折手术的患者术中静脉推注和输注右美托咪定与氯胺酮对术后镇痛的效果。
在这项前瞻性随机双盲对照研究中,选择75例年龄在18 - 65岁之间拟行择期手术的患者,随机分为三组,分别接受氯胺酮(K组)、右美托咪定(D组)和生理盐水(对照组C)。使用数字评分量表(NRS)评估术后疼痛。记录镇痛持续时间和镇痛药物消耗量。采用t检验和卡方检验比较两组,采用单因素方差分析及事后分析比较三组。
通过疼痛减轻(NRS量表)和术后急救镇痛药需求减少评估,氯胺酮组患者术后镇痛效果更好(P < 0.001)。与其他两组相比,K组感觉阻滞和运动阻滞的持续时间延长(P < 0.001)。
在蛛网膜下腔阻滞下行股骨骨折手术的患者中,术中使用静脉氯胺酮在术后镇痛方面优于右美托咪定。