Objective： To investigate the adjuvant effect of intraoperative and postoperative low-dose ketamine administration to remifentanil consumption in patient-controlled analgesia （PCA） for lower limb fracture. Methods...Objective： To investigate the adjuvant effect of intraoperative and postoperative low-dose ketamine administration to remifentanil consumption in patient-controlled analgesia （PCA） for lower limb fracture. Methods： A total of 200 patients with lower limb fracture receiving the surgery were randomly divided into 4 groups. In Groups A, B and C, patients received 0.5 mg/kg ketamine infusion under general anesthesia, and ketamine in a dose of 0.1 mg/kg, 0.05 mg/kg, 0.01 mg/kg per hour continuously for 24 hours after surgery, respectively. The control group （Group D） received an equivalent volume of normal saline only. With 20 μg/ml remifentanil in normal saline, postoperative PCA was administered with a background infusion at 2 ml/h following 2 ml as a loading dose and lml demand dose with a 3-minute lockout period. Remifentanil consumption, 11-point visual analog scale （VAS） scores, global satisfaction score （GSS）, and side effects were also recorded by the acute pain service. Results： Cumulative PCA remifentanil consumption in Groups A and B were （1378±377）μg and （1531±402） μg, significantly lower than （1807±510） μg and （1838±523） μg in Groups C and D （P〈 0.01）. VAS scores in Groups A and B were significantly lower than those in Groups C and D （P〈 0.01）. In the first 12 hours after operation, GSS was improved （P〈0.01）. No respiratory depression was observed. No significant difference in side effects was observed among groups. Conclusion： Low-dose ketamine can relieve postoperative pain and moderately decrease remifentanil consumption for PCA, with no obvious side effects of ketamine.展开更多
文摘Objective： To investigate the adjuvant effect of intraoperative and postoperative low-dose ketamine administration to remifentanil consumption in patient-controlled analgesia （PCA） for lower limb fracture. Methods： A total of 200 patients with lower limb fracture receiving the surgery were randomly divided into 4 groups. In Groups A, B and C, patients received 0.5 mg/kg ketamine infusion under general anesthesia, and ketamine in a dose of 0.1 mg/kg, 0.05 mg/kg, 0.01 mg/kg per hour continuously for 24 hours after surgery, respectively. The control group （Group D） received an equivalent volume of normal saline only. With 20 μg/ml remifentanil in normal saline, postoperative PCA was administered with a background infusion at 2 ml/h following 2 ml as a loading dose and lml demand dose with a 3-minute lockout period. Remifentanil consumption, 11-point visual analog scale （VAS） scores, global satisfaction score （GSS）, and side effects were also recorded by the acute pain service. Results： Cumulative PCA remifentanil consumption in Groups A and B were （1378±377）μg and （1531±402） μg, significantly lower than （1807±510） μg and （1838±523） μg in Groups C and D （P〈 0.01）. VAS scores in Groups A and B were significantly lower than those in Groups C and D （P〈 0.01）. In the first 12 hours after operation, GSS was improved （P〈0.01）. No respiratory depression was observed. No significant difference in side effects was observed among groups. Conclusion： Low-dose ketamine can relieve postoperative pain and moderately decrease remifentanil consumption for PCA, with no obvious side effects of ketamine.
