Effect of Ketamine Instillation on Acute and Chronic Post Mastectomy Pain, a Dose Finding Clinical Study
Effect of Ketamine Instillation on Acute and Chronic Post Mastectomy Pain, a Dose Finding Clinical Study作者机构:Department of Anesthesia ICU and Pain Management South Egypt Cancer Institute Assiut University Assiut Egypt Department of Anesthesia ICU and Pain Management Faculty of Medicine Assuit University Assiut Egypt
出 版 物:《Open Journal of Anesthesiology》 (麻醉学期刊(英文))
年 卷 期:2022年第12卷第4期
页 面:146-159页
学科分类:1006[医学-中西医结合] 1005[医学-中医学] 100502[医学-中医临床基础] 10[医学] 100602[医学-中西医结合临床]
主 题:Acute Pain Breast Cancer Chronic Pain Ketamine Instillation Modified Radical Mastectomy
摘 要:Background: Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. Objectives: To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2, or 3 mg/kg) for acute and chronic post mastectomy pain (PMP). Methods: Ninety female patients with cancer breast, aged (18 - 60 yrs), weighted (50 - 90 kg), scheduled for modified radical mastectomy, randomly allocated into 3 groups to receive ketamine instillation after surgical homeostasis before wound closure (1 of 3 doses;1, 2, or 3 mg/kg as A, B or C groups respectively) patients were followed up for 48 h for acute pain (total morphine consumption, the first request of analgesia and visual analog scale at rest and movement (VASR/M), chronic pain by Leeds assessment of neuropathic signs and symptoms (LANSS) for six-months, hemodynamics, and side effects. Results: Median total dose of morphine consumption was 8 mg (5 - 10) versus 6 mg (6 - 7) in A and B groups respectively in the first 48 h postoperatively. Lowest VASR/M was recorded in C then B and lastly A group (P = 0.037). No patients in the C group requested analgesia versus thirty (100%) and nine (30%) patients in the A and B groups respectively with the first request of analgesia was 12 h (5 - 36) in the A group versus 30 h (12 - 36) in the B group respectively (P Conclusion: Ketamine instillation effectively controlled acute post mastectomy pain (PMP) in a dose-dependent manner and reduced the incidence and severity of chronic pain in patients who undergoing a modified radical mastectomy.