|Comparison of Intrapleural Bupivacaine vs. Bupivacaine Plus Ketamine on Post-Thoracoscopic Pain Control|
|Movassaghi R1, Dehghani AA2, Beheshtirouy S3|
|1Department of Anesthesiology Shohada Hospital: Tabriz, IRAN
2Department of Anesthesiology Imam Reza Hospital, Tabriz, IRAN
3Department of Thoracic Surgery, Imam Reza Hospital, Tabriz, IRAN
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Keywords : Bupivacaine, Ketamine, Postoperative, Pain, Thoracoscopy
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Objectives:During a video-assisted thoracoscopic surgery procedure, a tiny camera and surgical instruments are inserted into chest through small incisions in chest wall. The thoracoscope guiding the surgeon in performing the procedure. This procedure affected mortality and hospitalization days, better respiratory function after surgery, shorter admission period and less pain. Pain control after thoracic surgery is essential because untreated pain may lead to increase morbidity. The aim of this study was to compare the analgesic effectiveness of intrapleural administration of bupivacaine and a mixture of bupivacaine plus ketamine in the treatment of postoperative pain after thoracoscopy under general anesthesia.
Materials and Methods: In this double-blind study, 60 patients aged 18 to 60 years, thaAmerican Society of Anesthesiology (ASA) physical status I and II, scheduled for thoracoscopy under general anesthesia were randomly allocated to receive bupivacaine and ketamine (group BK n=30) and bupivacaine (group B n=30) all intrapleural. Time to the first dose and total dose of analgesic and patient’s pain score on visual analog scale(VAS) at 0, 6, 12, 18 and 24 hours after surgery and existence of ipsilateral shoulder pain had been recorded.
Results: The 2 groups did not differ significantly in age, gender, weight and duration of surgery. Pain score at 0, 6 and 12h in group BK was lower than B, but no difference at 18 and 24h. Time to the first analgesia was longer in BK group. The total dose of analgesia in BK was less than B. there was no difference between groups in ipsilateral shoulder pain.
Conclusion: Intrapleural low dose ketamine in combination with bupivacaine is effective in post-thoracoscopy pain control, but no effective in ipsilateral shoulder pain.
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