Effect of small dose ketamine combined with morphine used for postoperative analgesia in elderly patients undergoing total knee replacement surgery
10.3760/cma.j.issn.0254-9026.2013.12.018
- VernacularTitle:小剂量氯胺酮联合吗啡用于老年人膝关节置换术后镇痛治疗效果观察
- Author:
Jianghu CHEN
;
Jian LI
;
Dongxin WANG
- Publication Type:Journal Article
- Keywords:
Ketamine;
Morphine;
Analgesia;
Arthroplasty,replacement,knee
- From:
Chinese Journal of Geriatrics
2013;32(12):1322-1325
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect and safety of small dose ketamine combined with morphine for postoperative analgesia in elderly patients undergoing total knee replacement.Methods Sixty-two elderly (≥ 65 years old) patients undergoing total knee replacement under combined spinal-epidural anesthesia were randomly divided into two groups.In group MK,morphine (0.4 mg/ml) and ketamine (0.4 mg/ml) were used for postoperative analgesia.While in group MO,only morphine (0.4 mg/ml) was used for postoperative analgesia.Visual analogue scale (VAS) pain score,comfort level,Ramsay sedation level,cumulative morphine consumption,changes in vital signs (blood pressure,heart rate,respiration,blood oxygen saturation,etc) and occurrence of side-effects (pruritus,nausea and vomiting,psychiatric symptoms,etc) were recorded up to 48 h after surgery.Results The VAS pain scores were significantly lower in group MK than in group MO at time points of 4,8,12,24,36,48 h (Wald x2=16.713,P＜0.05),while the comfort levels were significantly higher in group MK than in group MO after surgery (Wald x2 11.238,P＜0.05).The total morphine consumption after 48 h was significantly lower in group MK than in group MO (t=3.807,P＜0.001).The incidence of postoperative nausea and vomiting was significantly lower in group MK than in group MO (x2 =4.356,P＝0.036).There were no significant differences in sedation level (Wald x2＝ 3.303,P＞0.05) and changes in vital signs (P＞0.05) between the two groups.No case with psychiatric symptoms was found in both groups.Conclusions When used for postoperative intravenous analgesia in elderly patients after total knee replacement,small-dose ketamine combined with morphine can provide better analgesic effects,decrease total consumption of morphine and the incidence of side-effects.
