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
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spelling	my-usm-ep.606262024-07-03T04:00:27Z 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 2019-11 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 http://eprints.usm.my/60626/ http://eprints.usm.my/60626/1/Rabiatul%20Aida%20Ramli-E.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
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
qualification_level	Master's degree
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
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2019
url	http://eprints.usm.my/60626/1/Rabiatul%20Aida%20Ramli-E.pdf
_version_	1804888976921722880

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

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