Online ISSN: 2515-8260

Keywords : Ketamine


Dr. Matturu Soumya; Dr. Amol Singam

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2083-2090

Background: Total intravenous anaesthesia is technique which uses various drugs in combination, given exclusively by IV route to provide general anaesthesia to the patient. TIVA provides a good surgical plane, rapid induction, smooth the emergence from anaesthesia and rapid recovery. Thus making it a desirable alternative for day care surgeries. Propofol is IV anaesthetic agent, having a pharmacological profile favorable for TIVA. However it is known to cause respiratory depression and dose-dependent hypotension, and due its lack of analgesic properties there is a limitation on its employment. Ketamine known for its hypnotic, analgesic and amnesic properties. Butorphanol seems to provide good analgesia but is associated with adverse effects like cardio depressant action, dizziness and sedation.
Methods: A total of 60 patients who will be undergoing surgeries under TIVA in the age group of 20-60yrs will be taken up for this study. They would be further divided in two groups, Group PK will receive ketamine 1mg/kg 1 min prior to administration of propofol and propofol and group PB will receiving butorphanol 20μg/kg 1min prior to administration of propofol. Propofol will be given at a dose of 1.5ml/kg to both the groups during induction . In both the groups anaesthesia will be maintained with propofol 9mg/kg/hr . Patient will be monitored for various parameters such as non-invasive heamodynamic, respiratory parameters. Incidence of pain on injection Propofol, post-operative sedation, nausea, vomiting will also be looked for.
Results and Conclusion : Expected outcome of this study is that the combination of Propofol-ketamine, offers a better haemodynamic and respiratory stability over propofol- butorphanol combination. Pain on injection will be better attenuated by butorphaol than ketamine.

Effect of ketamine as an adjunct to opioid for pain control in traumatic patients

Mehdi Arzani Shamsabadi; Mohammad Darvishi; Masoud Shahabian; Seyed Zia Hejripour

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4438-4443

Background: Pain management results in better outcomes in traumatic patients in the emergency ward. Use of non-opioids facilitates the elimination of the adverse effects of opioid. Regarding this, the present study was conducted to examine the effect of ketamine as an adjunct to opioids for pain control in traumatic patients in a tertiary healthcare center in Tehran, Iran. Methods and materials: This double-blind randomized clinical trial was conducted on 160 traumatic patients admitted to the Emergency Department of Besat Hospital, Tehran, Iran, in 2018. The study population was randomly assigned into two groups of intervention and placebo. The intervention group one of which received 0.05 mg/kg opioid (i.e., morphine) plus 0.1 mg/kg ketamine, and placebo group the other one was provided with the same amount of morphine opioid plus placebo. The pain was recorded up to 120 min and compared between the groups. Results: Based on the obtained results, 23 (28.8%) and 16 (20%) patients in the ketamine intervention and control placebo groups had side effects, respectively, showing no significant difference (P=0.197). In addition, the pain significantly reduced in both groups (P=0.001). However, the results of repeated measures ANOVA revealed no statistically significant difference between the two groups in terms of pain reduction trend (P=0.275). Conclusion: Based on the results, it can be concluded that ketamine has no superior effect when administered as an adjunct to opioid for pain control in traumatic patients.