Comparison of the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia

Kazemnejad , Kazem; Hosseini , Seyed Masoud; Haydari , Ahmad; Ghourchaei , Arazberdi

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Volume 22, Issue 1 (3-2020)

J Gorgan Univ Med Sci 2020, 22(1): 1-6

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Comparison of the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia

Kazem Kazemnejad¹

, Seyed Masoud Hosseini²

, Ahmad Haydari³

, Arazberdi Ghourchaei ^*

⁴

1- Assistant Professor, Department of Anesthesiology, Golestan University of Medical Sciences, Gorgan, Iran.
2- Resident in Anesthesiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
3- M.Sc in Biostatics, Deputy of Research and Technology, Golestan University of Medical Sciences, Gorgan, Iran.
4- Associate Professor, Department of Anesthesiology, Golestan University of Medical Sciences, Gorgan, Iran , drghourchaei@yahoo.com

Abstract: (4919 Views)

Background and Objective: Appropriate analgesia after surgery helps patients feel more comfortable and increase the mobility of them. The purpose of this study was to compare the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia.
Methods: This double blinded, randomized clinical trial study was done on 60 patients undergoing elective inguinal hernia under general anesthesia. Subjects were randomly assigned into three groups including control, Ketamine and Lidocaine groups. Subjects in Ketamine group were received infiltration of subcutaneous Ketamine 0.5 mg/kg/bw after closure of surgical incision. Subjects in Lidocaine group were received infiltration of subcutaneous Lidocaine 1 mg/kg/bw at the time of wound suturing. Subjects in control group did not receive Ketamine and Lidocaine. The visual analogue scale (VAS) of pain and vital signs were continuously assessed. If VAS≥3, 100 mg diclofenac suppository was administered and if there were no response, 30 mg intravenous pethidine was also administered. The complications, including hallucination, nystagmus, nausea, vomiting and drowsiness in patients were also recorded.
Results: The mean VAS at 1, 2 hours after surgery were significantly lower in the Ketamine and Lidocaine group in compared to control group (P<0.05). No significant adverse effect was observed in the Ketamine group.
Conclusion: For reduction of pain, administration of subcutaneous Ketamine is recommended due to no adverse effect and anti analgesic effect of Ketamine is similar to Lidocaine.

Keywords: Pain, Inguinal hernia, Analgesia, Lidocaine, Ketamine
Article ID: Vol22-01

Full-Text [PDF 186 kb] (15081 Downloads)

Type of Study: Original Articles | Subject: Anesthesiology and Pain

References

1. Arroyo-Novoa CM, Figueroa-Ramos MI, Miaskowski C, Padilla G, Paul SM, Rodríguez-Ortiz P, et al. Efficacy of small doses of ketamine with morphine to decrease procedural pain responses during open wound care. Clin J Pain. 2011 Sep; 27(7): 561-66. doi: 10.1097/AJP.0b013e318211936a

2. Benítez-Rosario MA, Salinas-Martín A, González-Guillermo T, Feria M. A strategy for conversion from subcutaneous to oral ketamine in cancer pain patients: effect of a 1:1 ratio. J Pain Symptom Manage. 2011 Jun; 41(6): 1098-105. doi: 10.1016/j.jpainsymman.2010.08.017

3. Honarmand A, Safavi M, Karaky H. Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy. J Pain Res. 2012; 5: 1-6. doi: 10.2147/JPR.S26476

4. Hurley RW, Wu CL. Acute postoperative pain. In: Miller RD (ed). Miller's Anesthesiology. Philadelphia: Churchill Livingstone. 2015; pp: 2974-96.

5. Durmus M, Kadir But A, Saricicek V, Ilksen Toprak H, Ozcan Ersoy M. The post-operative analgesic effects of a combination of gabapentin and paracetamol in patients undergoing abdominal hysterectomy: a randomized clinical trial. Acta Anaesthesiol Scand. 2007 Mar; 51(3): 299-304. doi: 10.1111/j.1399-6576.2006.01237.x

6. Rakic AM, Golembiewski J. Low-dose ketamine infusion for postoperative pain management. J Perianesth Nurs. 2009 Aug; 24(4): 254-57. doi: 10.1016/j.jopan.2009.05.097

7. Suppa E, Valente A, Catarci S, Zanfini BA, Draisci G. A study of low-dose S-ketamine infusion as "preventive" pain treatment for cesarean section with spinal anesthesia: benefits and side effects. Minerva Anestesiol. 2012 Jul; 78(7): 774-81.

8. Safavi MR, Honarmand A, Barati B, Mahjobipor H. [The pre-emptive analgesic effect of peritonsillar infiltration of ketamine for postoperative pain relief in children following tonsillectomy]. Med J Mashhad Univ Med Sci. 2009; 52(1): 37-42. [Article in Persian]

9. Gu X, Wu X, Liu Y, Cui S, Ma Z. Tyrosine phosphorylation of the N-Methyl-D-Aspartate receptor 2B subunit in spinal cord contributes to remifentanil-induced postoperative hyperalgesia: the preventive effect of ketamine. Mol Pain. 2009 Dec; 5: 76. doi: 10.1186/1744-8069-5-76

10. Safavi M, Honarmand A, Nematollahy Z. Pre-incisional analgesia with intravenous or subcutaneous infiltration of ketamine reduces postoperative pain in patients after open cholecystectomy: a randomized, double-blind, placebo-controlled study. Pain Med. 2011 Sep; 12(9): 1418-26. doi: 10.1111/j.1526-4637.2011.01205.x

11. Manouchehrian N, Behboodi S. [The Effect of Subcutaneous Ketamine Infiltration on Postoperative Pain in Elective Cesarean Section under Spinal Anesthesia]. Avicenna J Clin Med. 2015; 21(4): 286-93. [Article in Persian]

12. Sacevich C, Semakuba B, McKay WP, Thakore S, Twagirumugabe T, Nyiligira J. Subcutaneous ketamine for postoperative pain relief in Rwanda: a randomized clinical trial. Can J Anaesth. 2018 Feb; 65(2): 170-77. doi: 10.1007/s12630-017-1009-7

13. Tawfic QA. A review of the use of ketamine in pain management. J Opioid Manag. 2013 Sep-Oct; 9(5): 379-88. doi: 10.5055/jom.2013.0180

14. Zekry O, Gibson SB, Aggarwal A. Subanesthetic, Subcutaneous Ketamine Infusion Therapy in the Treatment of Chronic Nonmalignant Pain. J Pain Palliat Care Pharmacother. 2016 Jun; 30(2): 91-98. doi: 10.3109/15360288.2016.1161690

15. Hardy J, Quinn S, Fazekas B, Plummer J, Eckermann S, Agar M, et al. Randomized, double-blind, placebo-controlled study to assess the efficacy and toxicity of subcutaneous ketamine in the management of cancer pain. J Clin Oncol. 2012 Oct; 30(29): 3611-17. doi: 10.1200/JCO.2012.42.1081

16. Behaeen K, Soltanzadeh M, Nesioonpour Sh, Ebadi A, Olapour AR, Salani SMM. Analgesic Effect of Low Dose Subcutaneous Ketamine Administration Before and after Cesarean Section. Iran Red Crescent Med J. 2014; 16(3): e15506. doi: 10.5812/ircmj.15506

17. Tuchscherer J, McKay WP, Twagirumugabe T. Low-dose subcutaneous ketamine for postoperative pain management in Rwanda: a dose-finding study. Can J Anaesth. 2017 Sep; 64(9): 928-34. doi: 10.1007/s12630-017-0914-0

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Kazemnejad K, Hosseini S M, Haydari A, Ghourchaei A. Comparison of the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia. J Gorgan Univ Med Sci 2020; 22 (1) :1-6
URL: http://goums.ac.ir/journal/article-1-3322-en.html

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