A comparison of bupivacaine, bupivacaine-fentanyl and bupivacaine-ketamine in patient-controlled epidural analgesia; [Hasta Kontrollü Analjezi̇de Epi̇dural Bupi̇vakȧin Bupi̇vakai̇n-Fentani̇l ve Bupi̇vakai̇n-Ketaṁiṅin Etki̇leri̇ni̇n Karşilaştirilmasi]

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2006

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Background: In this study, the analgesic and side effects of bupivacaine with combinations of ketamine and fentanyl using patient-controlled-epidural analgesia (PLEA) methods in the postoperative period of total abdominal hysterectomy (TAH) operations were compared. Method: Sixty ASA I-II patients aged between 18-65 years were included, Following epidural catheterization the patients were operated under general anesthesia, After surgery, patients were randomly allocated to 3 groups in a double-blinded fashion to receive PCEA as Group B: 0.125% bupivacaine, Group BF: 0.125% bupivacaine plus 0.1 mg fentanyl and Group BK.: 0.125% bupivacaine plus 40 mg ketamine solutions (10 mL loading dose, 5 mL bolus dose, 10 min lockout time, 30 mL in a 4 hour limit) in 100 mL salin. Hemodynamic parameters, VAS scores, total analgesic consumption, additional analgesic requirements, sedation scores, satisfaction scores and probable side-effects were evaluated for 24 h. Results: Total analgesic consumption was lower in the fentanyl group (p<0.05), Therefore VAS scores in the fentanyl group were lower than the other groups at the 1 hour and the 24 hour assessments (p<0.05), Postoperative analgesic consumption was lower in the ketamine group compared to the control group, There was no difference in side effects and additional analgesic requirement between the groups. Conclusion: Fentanyl and ketamine may be used safely by PCEA for postoperative analgesia, These adjuncts increase analgesic quality and patient satisfaction without increased side effects.

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