Document Detail


Postoperative analgosedation with S(+)-ketamine decreases the incidences of postanesthetic shivering and nausea and vomiting after cardiac surgery.
MedLine Citation:
PMID:  19043378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Along with postoperative nausea and vomiting (PONV), postanesthetic shivering (PAS) is one of the leading causes of distress postoperatively. Previous studies report on a decrease in incidence of PAS due to ketamine administration; however, the S(+) isomer of ketamine has not been evaluated before. Additionally the administration of ketamine minimizes the use of opioids, one of the most important risk factor of PONV. The aim of the present study was to evaluate the efficacy of S(+)-ketamine in the prophylaxis of both PAS and PONV in patients undergoing cardiac surgery. MATERIAL/METHODS: After ethics committee approval and written informed consent from the patients, 54 patients scheduled for coronary artery bypass graft surgery (CABG) were studied for both postanesthetic shivering and PONV. The sedation on the ICU was maintained using continuous infusion of propofol (1-3 mg x kg(-1) x h(-1)) and if necessary boli of 3.75 mg piritramide. At arrival in the ICU patients supplementary received either S(+)-ketamine (2 mg x kg(-1) x h(-1); group A; n=27) or 0.9% saline as placebo (group B; n=27) in a double-blind fashion. The severity of PAS was assessed by using a five-point rating scale. Fifteen minutes after extubation and 24 hours postoperatively, patients were asked about occurrence of PONV. RESULTS: In group A 4 (14.8%) patients suffered from PAS compared to 12 (44.4%) in the control group (p<0.05). The severity of shivering was significantly lower in group A than in group B (p<0.05). In group A, patients showed a significant lower incidence of PONV (3.7% vs. 33.3%) and vomiting (3.7% vs. 22.2%) compared to patients of group B (p<0.05). CONCLUSIONS: S(+)-ketamine reduced both postanesthetic shivering and postoperative nausea and vomiting, when administered for postoperative analgosedation.
Authors:
Swen N Piper; Ralf B Beschmann; Andinet Mengistu; Wolfgang H Maleck; Joachim Boldt; Kerstin D Röhm
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  14     ISSN:  1643-3750     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-01     Completed Date:  2009-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  PI59-65     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Klinikum Ludwigshafen, Ludwigshafen, Germany. swen.n.piper@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia / adverse effects*
Case-Control Studies
Coronary Artery Bypass*
Female
Humans
Hypnotics and Sedatives / administration & dosage*
Incidence
Intensive Care Units
Ketamine / administration & dosage*
Male
Middle Aged
Nausea / chemically induced,  prevention & control*
Postanesthesia Nursing*
Postoperative Complications*
Vomiting / chemically induced,  prevention & control*
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 6740-88-1/Ketamine

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


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