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Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia

Background: Pre-emptive analgesia is important for post-operative analgesia and reducing opioids requirement and their side effects after major surgery. The aim of this study is to compare the efficacy of low dose IV ketamine in combination with IV parecoxib versus IV ketamine alone as pre-emptiv...

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Main Author: Ramli, Rabiatul Aida
Format: Thesis
Language:English
Published: 2019
Subjects:
R Medicine
RD Surgery
Online Access:http://eprints.usm.my/60626/1/Rabiatul%20Aida%20Ramli-E.pdf
http://eprints.usm.my/60626/
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spelling my.usm.eprints.60626 http://eprints.usm.my/60626/ Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia Ramli, Rabiatul Aida R Medicine RD Surgery Background: Pre-emptive analgesia is important for post-operative analgesia and reducing opioids requirement and their side effects after major surgery. The aim of this study is to compare the efficacy of low dose IV ketamine in combination with IV parecoxib versus IV ketamine alone as pre-emptive analgesia in patients undergoing laparotomy under general anaesthesia. Methods: A total of 48 patients, scheduled for laparotomy under general anaesthesia were randomised into two different groups of pre-emptive analgesia: Group R: low dose IV ketamine 0.3mg/kg in combination with IV parecoxib 40 mg (n= 24) and Group C: IV ketamine 0.3mg/kg alone in combination with placebo (normal saline) (n= 24) and administered before induction of anaesthesia. Both groups received standardized technique of general anaesthesia and post-operative analgesia using patient-controlled analgesia of morphine (PCAM). Both groups were assessed for dosage of rescue analgesia requirement at the recovery bay, pain intensity using visual analogue scale (VAS) over 24 hours, time for the first PCAM demand and total dose requirement of intra-operative and post-operative opioids. Results: Group R showed lower dose of rescue analgesia requirement at recovery bay [6.25 (16.9) vs 20.8 (28); p= 0.035], longer time for the first PCAM demand [70.8 (40) vs 22.2 (15.7); p< 0.001], less total requirement of PCAM within 24 hours post-operatively [-8.04 (4.6) vs -16.8 (6.46); p< 0.001] and less VAS at an hour and subsequently 4 hourly interval over 24 hours than Group C. Conclusion: Combination of low dose IV ketamine and IV parecoxib was more effective as pre-emptive analgesia compared to IV ketamine alone for post laparotomy patients who were on PCAM as post-operative analgesia. 2019-11 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/60626/1/Rabiatul%20Aida%20Ramli-E.pdf Ramli, Rabiatul Aida (2019) Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia. Masters thesis, Universiti Sains Malaysia.
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic R Medicine
RD Surgery
spellingShingle R Medicine
RD Surgery
Ramli, Rabiatul Aida
Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
description Background: Pre-emptive analgesia is important for post-operative analgesia and reducing opioids requirement and their side effects after major surgery. The aim of this study is to compare the efficacy of low dose IV ketamine in combination with IV parecoxib versus IV ketamine alone as pre-emptive analgesia in patients undergoing laparotomy under general anaesthesia. Methods: A total of 48 patients, scheduled for laparotomy under general anaesthesia were randomised into two different groups of pre-emptive analgesia: Group R: low dose IV ketamine 0.3mg/kg in combination with IV parecoxib 40 mg (n= 24) and Group C: IV ketamine 0.3mg/kg alone in combination with placebo (normal saline) (n= 24) and administered before induction of anaesthesia. Both groups received standardized technique of general anaesthesia and post-operative analgesia using patient-controlled analgesia of morphine (PCAM). Both groups were assessed for dosage of rescue analgesia requirement at the recovery bay, pain intensity using visual analogue scale (VAS) over 24 hours, time for the first PCAM demand and total dose requirement of intra-operative and post-operative opioids. Results: Group R showed lower dose of rescue analgesia requirement at recovery bay [6.25 (16.9) vs 20.8 (28); p= 0.035], longer time for the first PCAM demand [70.8 (40) vs 22.2 (15.7); p< 0.001], less total requirement of PCAM within 24 hours post-operatively [-8.04 (4.6) vs -16.8 (6.46); p< 0.001] and less VAS at an hour and subsequently 4 hourly interval over 24 hours than Group C. Conclusion: Combination of low dose IV ketamine and IV parecoxib was more effective as pre-emptive analgesia compared to IV ketamine alone for post laparotomy patients who were on PCAM as post-operative analgesia.
format Thesis
author Ramli, Rabiatul Aida
author_facet Ramli, Rabiatul Aida
author_sort Ramli, Rabiatul Aida
title Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
title_short Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
title_full Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
title_fullStr Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
title_full_unstemmed Comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
title_sort comparison of the pre-emptive analgesia of low dose intravenous ketamine in combination with intravenous parecoxib versus intravenous ketamine alone on patients undergoing laparotomy under general anaesthesia
publishDate 2019
url http://eprints.usm.my/60626/1/Rabiatul%20Aida%20Ramli-E.pdf
http://eprints.usm.my/60626/
_version_ 1804065722779828224
score 13.211869

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