Anesth Pain Med.  2013 Apr;8(2):91-98.

The effect of remifentanil and ketamine on intraoperative hemodynamics and postoperative pain in gastrectomy with sevoflurane based anesthesia

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Korea Institute of Radiological and Medical Science, Seoul, Korea. jiheui0255@naver.com

Abstract

BACKGROUND
Remifentanil could require an appropriate pain strategy to prevent unacceptable pain in the postoperative period. We investigated the effect of perioperative ketamine for nociception and remifentanil hyperalgesia after gastrectomy when we used intraoperative remifentanil infusion for hemodynamic control.
METHODS
Eighty patients scheduled for gastrectomy were randomly included in this trial. In control group (C), patients received normal saline. In ketamine group (K), patients received ketamine perioperatively. In remifentanil group (R), patients received remifentanil during operation. In remifentanil and ketamine group (RK) patients received remifentanil intraoperatively and ketamine perioperatively. Hemodynamic indexes were recorded during anesthesia. Visual analogue scale (VAS), cumulative analgesic requirement, and side effects were recorded during 36 h after operation.
RESULTS
The requirement of vasodepressants was significantly increased in C and K group. Morphine consumption and agitation were significantly increased in R group at the postanesthetic recovery room. The analgesic demand of R group was greater than that in other groups. The VAS scores of K group were significantly lower than those of other groups at the ward.
CONCLUSIONS
Intraoperative use of remifentanil with sevoflurane may be related to increased pain during early postanesthetic period. Perioperative low-dose ketamine decreased intraoperative remifentanil use and postoperative morphine consumption without increasing the incidence of side effects.

Keyword

Hemodynamics; Hyperalgesia; Ketamine; Nociception; Remifentanil

MeSH Terms

Anesthesia
Dihydroergotamine
Gastrectomy
Hemodynamics
Humans
Hyperalgesia
Incidence
Ketamine
Methyl Ethers
Morphine
Nociception
Pain, Postoperative
Piperidines
Postoperative Period
Recovery Room
Dihydroergotamine
Ketamine
Methyl Ethers
Morphine
Piperidines
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