Assuntos
Anestésicos Locais/administração & dosagem , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor Pós-Operatória/terapia , Fusão Vertebral/efeitos adversos , Músculos Abdominais/inervação , Idoso , Analgesia Controlada pelo Paciente/métodos , Anestesia Geral , Bupivacaína/administração & dosagem , Bupivacaína/análogos & derivados , Feminino , Humanos , Levobupivacaína , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Período Perioperatório , Resultado do Tratamento , Ultrassonografia de IntervençãoRESUMO
BACKGROUND: It is reported that ketamine, a N-methyl-D-aspertate (NMDA) receptor antagonist, can provide analgesic effect improving postoperative pain management and decrease the supplementary analgesic requirement. We investigated the analgesic sparing effect of ketamine for postoperative pain in children undergoing surgery of body surface. METHODS: Fifty eight patients (0-9 yrs) who had surgery of body surface were divided into two groups (ketamine : n = 27, Group K or control : n = 31, Group N). Postoperative analgesia extracted from charts was retrospectively evaluated by the times patients used analgesics until discharge after the operations. Chi-square and Mann-Whitney U tests were used for statistical analysis. Results : The ketamine group received an intrave- nous bolus of ketamine (1 mg - kg-1) before surgical skin incision. However, there were no significant differ- ences of usage (Group K vs Group N : 4/27 vs 7/31, P=0.45) and frequency of supplementary analgesic us- ages (P=0.85) among groups. In addition, there were also no significant demographic differences between the two groups. Conclusions : Our investigation suggests that the intravenous bolus of ketamine (1 mg - kg-1) before surgical skin incision does not decrease the supple- mentary analgesic requirements on postoperative pain management in pediatric surgery of the body surface.