Document Detail


Analgesic efficacy of the intra-articular administration of S(+)- ketamine in patients undergoing total knee arthroplasty.
MedLine Citation:
PMID:  22999399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA) is associated with significant postoperative pain. Many intra-articular (IA) agents have been used for postoperative analgesia with inconsistent outcomes. Ketamine's enantiomer S(+), S(+)- ketamine, was recently introduced commercially, with higher analgesic potency and less side effects than the racemic form. An experimental prospective randomized double-blind study was conducted to evaluate the analgesic efficacy of intra-articular S(+)- ketamine in patients undergoing primary TKA.
METHOD: In total, 56 patients were evaluated and allocated into three groups: Group A (n=19) received 0.25mg.kg(-1) of S(+)- ketamine diluted in 20mL of saline solution 0.9%; Group B (n=17) received 0.5mg.kg(-1) of S(+)- ketamine diluted in the same way; and Group C (n=20) received only 20mL of intra-articular saline 0.9%, immediately after surgery and drain placement. All patients had access to rescue analgesic therapy, with the use of intravenous morphine alone. Evaluations were made 2, 6, 12, and 24 hours postoperatively, with measurement of pain intensity by Visual Analogue Scale (VAS), use of rescue medication by the evaluation of the time elapsed between the intra-articular injection of the solution and first dose of rescue, total consumption within 24 hours, and adverse effects.
RESULTS: The S(+)- ketamine groups had lower pain scores compared with the saline group. The lowest dose of intra-articular S(+)- ketamine (Group A: 0.25mg.kg(-1)) resulted in better pain scores and less rescue analgesia, with longer time to first request. Adverse effects were infrequent. The results with lower pain scores in groups using S(+)- ketamine are a trend, as there was no statistical significance between groups.
CONCLUSION: In this study, with this sample, the analgesic effect of IA S(+)- ketamine was not superior to saline solution in the postoperative period of TKA.
Authors:
Hireno Guará Sobrinho; João Batista Santos Garcia; Jose Wanderley Vasconcelos; José Carlos Amaral Sousa; Letácio Santos Garcia Ferro
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Revista brasileira de anestesiologia     Volume:  62     ISSN:  1806-907X     ISO Abbreviation:  Rev Bras Anestesiol     Publication Date:    2012 Sep-Oct
Date Detail:
Created Date:  2012-09-24     Completed Date:  2013-11-22     Revised Date:  2014-02-05    
Medline Journal Info:
Nlm Unique ID:  0401316     Medline TA:  Rev Bras Anestesiol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  665-75     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Editora Ltda. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analgesia / methods*
Analgesics / administration & dosage*
Arthroplasty, Replacement, Knee*
Double-Blind Method
Female
Humans
Injections, Intra-Articular
Ketamine / administration & dosage*
Male
Middle Aged
Pain, Postoperative / prevention & control*
Prospective Studies
Chemical
Reg. No./Substance:
0/Analgesics; 690G0D6V8H/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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