Ketamine
Conditions
Keywords
Ketamine, Morphine, Laparotomy Myomectomy
Brief summary
Ketamine is an antagonist of N-methyl-d-aspartate (NMDA) receptor that not only abolishes peripheral afferent noxious stimulation, but it may also prevent central sensitization of nociceptors as shown in animal studies with excellent analgesic property even in subanesthetic doses. It is readily available and is being used currently, even by non-Anesthesiologists, to provide sedation for minor procedures.(.. Low-dose ketamine infusion in the perioperative period has shown to produce analgesia and decrease the requirements of opioid analgesics.. In obstetrics, it is being used as an adjunct to an inadequately functioning spinal anesthesia for caesarean section, as an induction agent for cesarean section and also to provide analgesia during labor in intermittent boluses.
Detailed description
Ketamine is an antagonist of N-methyl-d-aspartate (NMDA) receptor that not only abolishes peripheral afferent noxious stimulation, but it may also prevent central sensitization of nociceptors as shown in animal studies with excellent analgesic property even in subanesthetic doses. It is readily available and is being used currently, even by non-Anesthesiologists, to provide sedation for minor procedures.(.. Low-dose ketamine infusion in the perioperative period has shown to produce analgesia and decrease the requirements of opioid analgesics.. In obstetrics, it is being used as an adjunct to an inadequately functioning spinal anesthesia for caesarean section, as an induction agent for cesarean section and also to provide analgesia during labor in intermittent boluses.
Interventions
DRUGKetamine group:
Ketamine group: will be administered ketamine in a loading dose of 0.2 mg/kg over 5 min pre incision followed-by an infusion at 0.2 mg/kg/h until the end of surgery.
DRUGControl group
where normal saline was administered as a loading dose then infused with same rate of another group, throughout the whole surgery.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
The study will include 80 ASA physical status I, II patients with age between 18- 50 years old scheduled for elective myomectomy under general anesthesia
Exclusion criteria
Patients who refused to participate, ASA physical status III, IV, patients younger than 18 years or \> 50 years old, BMI \> 30, history of epilepsy. Patients having a history of parenteral or oral analgesics within the last 24 hours before initiation of operation or those having allergy to study agents will be excluded. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| total Amount of Morphine need intraoperative and postoperative | up to 24 hours | adjusted to keep the HR and mean arterial blood pressure within 20% of the pre induction values. Starting from the induction till the end of the operation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain score | up to 24 hours | assessment of patient by VAS sore 0= no pain , 10= sever pain |
| Number of Participants with hallucinations | up to 24 hours | complication |
| duration of surgery | UP TO 1 HOURE | time from start to end |
| Number of Participants with nausea and vomiting | up to 24 hour | complication |
| Number of Participants with sedation | up to 24 hour | complication |
| Number of Participants with sleep disturbances | up to 24 hours | complication |
Countries
Egypt
Outcome results
None listed