فهرست مطالب negin ghadami

Choosing an appropriate anesthetic agent for induction and maintenance of anesthesia is very important in hemodynamic stability and pain control. The aim of this study was to compare the effects of ketamine-remifentanil combination with ketamine-propofol combination on pain, agitation and hemodynamic changes during closed reduction of nasal fracture.

This single-blind clinical trial included 80 patients between 16 and 18 years of age with ASA1 physical status who had undergone closed reduction for nasal fracture. Patients in the group 1 received 0.75 mg/kg ketamine and 2µ/kg remifentanil and group 2 received 0.75 mg/kg ketamine and 1.5 mg/kg propofol to induce anesthesia. Hemodynamic changes (heart rate, systolic and diastolic blood pressure), pain intensity, agitation, as well as nausea and vomiting and changes in arterial hemoglobin oxygen saturation during surgery were evaluated immediately after induction of anesthesia and after surgery every 15 minutes for 2 hours.

Based on the statistical analysis of the patients' data, the mean heart rate and pain intensity scores in the ketamine-remifentanil group were significantly lower than those in the ketamine-propofol group (P <0.05). Mean systolic and diastolic blood pressure and RASS scores in the two groups did not show any statistically significant differences (P> 0.05). The incidence of nausea was higher in the ketamine-remifentanil group and the decrease in oxygen saturation was higher in the ketamine-propofol group (P <0.05). There was no statistically significant difference between the two groups in regard to incidence of vomiting (P> 0.05).

Based on the results of this study, it seems that use of ketamine-remifentanil combination in comparison to ketamine-propofol in closed reduction of nasal fracture is associated with greater hemodynamic stability, higher analgesic effect and fewer complications.

The aim of this study was to compare the analgesic effects of pregabalin and ketamine on reducing pain after abdominal hysterectomy.

In this double-blind clinical trial, one hundred forty ASA I and II patients of age range 30-60 years scheduled for abdominal hysterectomy undergoing general anesthesia in 2018, were randomly divided into 4 equal groups. Pregabalin group received 300 mg oral pregabalin, ketamine group received 0.3 mg/kg of intravenous ketamine, and pregabalin- ketamine group received the combination of the two-above medication, and placebo group received the placebo and saline. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) at 2, 4, 6, 12, 18, and 24 hours after surgery. Also, the need for analgesic drugs and the frequency of repetitions were also recorded. Statistical analysis was performed using STATA, Version 14. A p- value less than 0.05 was considered statistically significant.

In the pregabalin and pregabalin-ketamine groups, pain in the first 6 hours after the end of operation was significantly less than the other two groups (p<0.05), but there was no significant difference between the 4 groups at 18 and 24 hours after surgery. The need for analgesic medications in the pregabalin group was lower than in other groups (p<0.05).

The results of this study show that the administration of oral pregabalin with and without intravenous ketamine before abdominal hysterectomy can decrease postoperative pain and reduce the need for analgesia.