تاثیر افزودن کتامین به ترکیب میدازولام و مورفین در بیماران با تحمل به مواد مخدر برای درد بعد از عمل جراحی
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Abstract:
Aims and Background: Uncontrolled postoperative pain may increase patients’ mortality and morbidity. One way to control postoperative pain is by using narcotics with patient controlled intravenous analgesia (PCIA) method. Some investigators try to use many drugs in combination with narcotics in order to come over the side effects and tolerance to them in special groups of patients. We tried to compare different doses of Ketamine in combination with Morphine and Midazolam as PCIA for control of postoperative pain in patients with history of opioid addiction. Materials and Methods: In a double blind clinical trial, 120 patients undergoing lower limb orthopedic surgery with history of opioid consumption, were randomized to receive PCIA of Morphine 20 mg + Midazolam 10mg± Ketamine 50 or 100 mg daily, for 48h after surgery. Pain scores as VAS and sedative level as Ramsay scale and other possible side effects such as nausea and vomiting, and any rescue doses of analgesics were evaluated at 2, 6,24,36,48 hours after initiation of PCIA. Findings: Considering pain acuity, groups with PCIA containing Ketamine in addition to Morphine and Midazolam, showed significant decrease in pain score. However, there was no difference in sedation score between the groups. There was a significant decrease in the number of rescue doses of analgesics in groups with PCIA containing Ketamine compared with the other group. There was no difference in any evaluation between the groups with PCIA containing 50 mg or 100mg Ketamine. Conclusions: A better control of pain was achieved in opioid addict patients with the addition of Ketamin either 50 or 100 mg to PCIA pump compared to the control group with PCIA containing Midazolam and Morphine. Keywords: Post operative pain, opioid addiction, Ketamine, PCIA
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اثر افزودن کتامین به مورفین در پمپ کنترل درد بیماران معتاد به اوپیوئید با درد پس از عمل جراحی ارتوپدی
Introduction: Post-operative pain reduction is one of the problems in the patients with preoperative narcotic dependency. Morphine is the most common drugs to control postoperative pain. Due to resistance to morphine and its side effects in addict patients, using of adjuvant drugs such as ketamine has increased. The aim of this study was to evaluate the effect of adding ketamine to morphi...
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full textاثر سولفات منیزیم بر میزان درد و مصرف مواد مخدر بعد از عمل جراحی فتق اینگوینال
Background and purpose: Although some studies have demonstrated the effect of magnesium sulphate on reducing the postoperative pain, some others have refuted this and showed that it has limited or no effect. In this study, the researchers investigated the effects of pre- and intraoperative magnesium sulphate administration on the postoperative pain and opioid consumption. Materials and methods...
full textبررسی اثرات افزودن کتامین به مورفین در پمپ تزریق وریدی کنترله توسط بیمار بعد از اعمال جراحی ارتوپدی
Background and aims: A routine method to control post-operative pain is patient-controlled intravenous analgesia (PCIA) using opioids. Regarding complications of opioids, it seems necessary to reduce their dosage and to improve the quality of analgesia using adjuvants. We aimed to assess the effect of adding ketamine to morphine in PCIA pumps for post-operative pain control in orthopedic pati...
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Journal title
volume 6 issue 2
pages 50- 58
publication date 2015-07
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