Comparison of Intraoperative Low-Dose Ketodex and Fentanyl Infusion for Postoperative Analgesia In Spine Surgery : A Prospective Randomized Double-Blind Study
STUDY DESIGN: Prospective randomized double-blind study.
PURPOSE: To assess the analgesic effects of the combination of a low-dose ketamine and dexmedetomidine (ketodex) infusion and compare it with that of fentanyl for postoperative analgesia after spine surgeries.
OVERVIEW OF LITERATURE: Adequate pain management following spine surgeries is crucial. Approximately 57% of patients experience inadequate pain control in the first 24 hours following elective spine surgery, which is attributable to the extensive soft tissue and muscle damage.
METHODS: The study included 60 patients graded American Society of Anesthesiologists I and II and scheduled for thoracolumbar spine surgery involving >3 vertebral levels. The patients were divided into two groups: group KD (ketodex) and group F (fentanyl). The primary objective was to compare the postoperative analgesic requirements among the groups. The secondary objectives included a comparison of the intraoperative anesthetic requirements, postoperative pain scores, hemodynamic parameters, side effects of the study drugs, and the duration of post-anesthesia care unit stay of both the groups.
RESULTS: Ketodex use prolonged the mean time to first rescue analgesia (22.00±2.30 hours vs. 11.69±3.02 hours, p <0.001) and reduced the requirement of rescue analgesics in the first 24 hours postoperatively compared to fentanyl use (70.00±8.16 μg vs. 113.31±36.65 μg, p =0.03). The intraoperative requirement of desflurane was comparable between the groups (p >0.05). The postoperative pain scores were significantly lower in the group KD than in group F at most timepoints (p <0.05). Patients in group KD had a shorter post-anesthesia care unit stay than group F did (p <0.001).
CONCLUSIONS: Low-dose ketodex could be a safe substitute for fentanyl infusion when employed as an anesthetic adjuvant for patients undergoing thoracolumbar spine surgeries involving >3 vertebral levels to achieve prolonged analgesia without any opioidrelated side effects.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Asian spine journal - 17(2023), 5 vom: 02. Okt., Seite 894-903 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Thappa, Priya [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesia |
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| Anmerkungen: |
Date Revised 05.11.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.31616/asj.2022.0439 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36081980X |
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| 100 | 1 | |a Thappa, Priya |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of Intraoperative Low-Dose Ketodex and Fentanyl Infusion for Postoperative Analgesia In Spine Surgery |b A Prospective Randomized Double-Blind Study |
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| 500 | |a Date Revised 05.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a STUDY DESIGN: Prospective randomized double-blind study | ||
| 520 | |a PURPOSE: To assess the analgesic effects of the combination of a low-dose ketamine and dexmedetomidine (ketodex) infusion and compare it with that of fentanyl for postoperative analgesia after spine surgeries | ||
| 520 | |a OVERVIEW OF LITERATURE: Adequate pain management following spine surgeries is crucial. Approximately 57% of patients experience inadequate pain control in the first 24 hours following elective spine surgery, which is attributable to the extensive soft tissue and muscle damage | ||
| 520 | |a METHODS: The study included 60 patients graded American Society of Anesthesiologists I and II and scheduled for thoracolumbar spine surgery involving >3 vertebral levels. The patients were divided into two groups: group KD (ketodex) and group F (fentanyl). The primary objective was to compare the postoperative analgesic requirements among the groups. The secondary objectives included a comparison of the intraoperative anesthetic requirements, postoperative pain scores, hemodynamic parameters, side effects of the study drugs, and the duration of post-anesthesia care unit stay of both the groups | ||
| 520 | |a RESULTS: Ketodex use prolonged the mean time to first rescue analgesia (22.00±2.30 hours vs. 11.69±3.02 hours, p <0.001) and reduced the requirement of rescue analgesics in the first 24 hours postoperatively compared to fentanyl use (70.00±8.16 μg vs. 113.31±36.65 μg, p =0.03). The intraoperative requirement of desflurane was comparable between the groups (p >0.05). The postoperative pain scores were significantly lower in the group KD than in group F at most timepoints (p <0.05). Patients in group KD had a shorter post-anesthesia care unit stay than group F did (p <0.001) | ||
| 520 | |a CONCLUSIONS: Low-dose ketodex could be a safe substitute for fentanyl infusion when employed as an anesthetic adjuvant for patients undergoing thoracolumbar spine surgeries involving >3 vertebral levels to achieve prolonged analgesia without any opioidrelated side effects | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Analgesia | |
| 650 | 4 | |a Dexmedetomidine | |
| 650 | 4 | |a Fentanyl | |
| 650 | 4 | |a Ketamine | |
| 650 | 4 | |a Ketodex | |
| 650 | 4 | |a Spine | |
| 700 | 1 | |a Singh, Nidhi |e verfasserin |4 aut | |
| 700 | 1 | |a Luthra, Ankur |e verfasserin |4 aut | |
| 700 | 1 | |a Deshpande, Pruthviraj |e verfasserin |4 aut | |
| 700 | 1 | |a Chauhan, Rajeev |e verfasserin |4 aut | |
| 700 | 1 | |a Meena, Shyam C |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Vishal |e verfasserin |4 aut | |
| 700 | 1 | |a Singla, Navneet |e verfasserin |4 aut | |
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