Effects of intraoperative low dose ketamine on remifentanil-induced hyperalgesia in gynecologic surgery with sevoflurane anesthesia / 대한마취과학회지
Korean Journal of Anesthesiology
;
: 238-243, 2011.
Artigo
em Inglês
| WPRIM
| ID: wpr-229275
ABSTRACT
BACKGROUND:
Remifentanil is useful during general anesthesia because of its rapid onset and short acting time. However, some studies report that due to opioid-induced hyperalgesia (OIH) and tolerance, remifentanil also increases early postoperative pain. The occurrence of OIH and opioid-induced tolerance is mainly thought to be due to central sensitization by the activation of NMDA receptors. Therefore, we investigated the effects of continuous infusion of ketamine, an NMDA receptor antagonist, on postoperative pain and the quantity of opioids used.METHODS:
40 patients scheduled to undergo laparoscopic gynecologic surgery were randomly allocated into two groups. Anesthesia was equally maintained with sevoflurane and 4 ng/ml of remifentanil in all patients. Ketamine (0.3 mg/kg) was injected and followed with a continuous dosage of 3 microl/kg/min in the ketamine group (n = 20) while the control group was injected and infused with an equal amount of normal saline. We compared postoperative VAS up to 7 hours and morphine demand through PCA.RESULTS:
Postoperative VAS and morphine demand was significantly lower in the ketamine group 2 and 3 hours after surgery, respectively.CONCLUSIONS:
When general anesthesia is maintained with sevoflurane and remifentanil in patients undergoing laparoscopic gynecologic surgery, continuous infusion of low dose ketamine decreased early postoperative pain and the quantity of opioids used.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Dor Pós-Operatória
/
Piperidinas
/
Procedimentos Cirúrgicos em Ginecologia
/
Anafilaxia Cutânea Passiva
/
N-Metilaspartato
/
Receptores de N-Metil-D-Aspartato
/
Sensibilização do Sistema Nervoso Central
/
Hiperalgesia
/
Analgésicos Opioides
/
Anestesia
Limite:
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Korean Journal of Anesthesiology
Ano de publicação:
2011
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS