ABSTRACT
To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. A randomized, double-blind comparative study. Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion [6 microg/kg/minute] or the same volume of saline. A visual analogue scale [VAS] was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery [p < 0.001]. Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects
ABSTRACT
To investigate intra cuff pressure changes in low-flow anesthesia [LFA] and high-flow [HFA] N2O anesthesia during moderate-duration surgical procedures. We carried out this prospective, randomized, single blind study at Numune Educational and Research Hospital, Ankara, Turkey between January to December 2005. Seventy patients aged between 18-65 years, American Society of Anesthesiologists [ASA] physical status grades I-III, undergoing elective surgery were enrolled in this study. Following a standardized induction, anesthesia was maintained with isoflurane [end-tidal 0.9-1%] at 4 L/minute for the HFA group, or 1 L/minute for the LFA group fresh gas flows. Endotracheal tube cuff [intra cuff] pressures were measured continuously with a pressure manometer, and inspired oxygen and N2O levels were noted every 10 minutes throughout the study. There was no significant difference between HFA and LFA groups for initial [first] cuff pressures [mean +/- SD, HFA=20.9 +/- 4.19, LFA=20.4 +/- 4.11, cmH2O], and maximum cuff pressures [MCP] [mean +/- SD, HFA=32.3 +/- 18.74, LFA=33.5 +/- 8.89, cmH2O] [p > 0.05]. The time to reach the maximum intra cuff pressure was significantly shorter in the LFA group [77.4 +/- 20.33 minutes], than the HFA group [89.3 +/- 23.94 minutes], [p=0.038]. Between the tenth and nineteenth minutes, inspired oxygen level was significantly higher in the HFA group [p=0.001], whereas inspired N2O was significantly higher in the LFA group [p=0.001]. The intra cuff pressures should be monitored carefully during LFA, since the duration to reach the maximum intra cuff pressures was shorter than that of HFA
Subject(s)
Humans , Male , Female , Nitrous Oxide , PressureABSTRACT
Myasthenia gravis is characterized by weakness and easy fatiguability of voluntary muscles. Myasthenic patients are sensitive to non-depolarizing relaxants. Sevoflurane, as an alternative, can be used to achieve good tracheal intubation. In this report, we present our experiences