Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy
Background: Pain after laparoscopic cholecystectomy is a complex physiologic reaction which can be associated with severe complications in various organs. In this study, we aimed to compare the effects of combination of dexamethasone, fentanyl, and ketamine with combination of metoclopramide, fentan...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | fas |
| Published: |
Isfahan University of Medical Sciences
2018-01-01
|
| Series: | مجله دانشکده پزشکی اصفهان |
| Subjects: | |
| Online Access: | http://jims.mui.ac.ir/index.php/jims/article/view/8736 |
| _version_ | 1797722113339031552 |
|---|---|
| author | Seyed Morteza Heidari Seyed Jalal Hashemi Farshad Babamir |
| author_facet | Seyed Morteza Heidari Seyed Jalal Hashemi Farshad Babamir |
| author_sort | Seyed Morteza Heidari |
| collection | DOAJ |
| description | Background: Pain after laparoscopic cholecystectomy is a complex physiologic reaction which can be associated with severe complications in various organs. In this study, we aimed to compare the effects of combination of dexamethasone, fentanyl, and ketamine with combination of metoclopramide, fentanyl, and ketamine on postoperative pain in patients undergoing laparoscopic cholecystectomy.
Methods: In this randomized, double-blind clinical trial study, 96 patients undergoing laparoscopic cholecystectomy aged 18-80 years were randomly allocated to three groups. Group 1 received dexamethasone (0.15 mg/kg), ketamine (0.3 mg/kg), and fentanyl (0.5 µg/kg); group 2 received metoclopramide (10 mg), ketamine (0.3 mg/kg), and fentanyl (0.5 µg/kg); and group 3 received only anesthetic induction drugs. The amount of pain and nausea were measured using the visual analog scale (VAS), as well as the frequency of vomiting and the amount of anti-nausea and drug administered at 2, 6, 12, and 24 hours after surgery.
Findings: Mean pain score at 2, 6, 12, and 24 hours after surgery was significantly lower in group 1 than other groups (P < 0.05). Postoperative consumption of opioid at 2 and 6 hours after surgery was significantly lower in group 1 than other groups (P < 0.05). The mean score of nausea and anti-emetic consumption were significantly lower in group 2 than other groups (P < 0.05).
Conclusion: The combination of three drugs, dexamethasone, ketamine, and fentanyl significantly reduced postoperative pain in patients undergoing laparoscopic cholecystectomy, whereas this effect was only partially attained with the combination of three drugs, metoclopramide, ketamine, and fentanyl. Both combinations of the drugs significantly reduced postoperative nausea and vomiting. |
| first_indexed | 2024-03-12T09:43:49Z |
| format | Article |
| id | doaj.art-167b869d3fc84c419c89094f734f340d |
| institution | Directory Open Access Journal |
| issn | 1027-7595 1735-854X |
| language | fas |
| last_indexed | 2024-03-12T09:43:49Z |
| publishDate | 2018-01-01 |
| publisher | Isfahan University of Medical Sciences |
| record_format | Article |
| series | مجله دانشکده پزشکی اصفهان |
| spelling | doaj.art-167b869d3fc84c419c89094f734f340d2023-09-02T13:01:15ZfasIsfahan University of Medical Sciencesمجله دانشکده پزشکی اصفهان1027-75951735-854X2018-01-01354541550155610.22122/jims.v35i454.87362708Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic CholecystectomySeyed Morteza Heidari0Seyed Jalal Hashemi1Farshad Babamir2Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranProfessor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranStudent of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranBackground: Pain after laparoscopic cholecystectomy is a complex physiologic reaction which can be associated with severe complications in various organs. In this study, we aimed to compare the effects of combination of dexamethasone, fentanyl, and ketamine with combination of metoclopramide, fentanyl, and ketamine on postoperative pain in patients undergoing laparoscopic cholecystectomy. Methods: In this randomized, double-blind clinical trial study, 96 patients undergoing laparoscopic cholecystectomy aged 18-80 years were randomly allocated to three groups. Group 1 received dexamethasone (0.15 mg/kg), ketamine (0.3 mg/kg), and fentanyl (0.5 µg/kg); group 2 received metoclopramide (10 mg), ketamine (0.3 mg/kg), and fentanyl (0.5 µg/kg); and group 3 received only anesthetic induction drugs. The amount of pain and nausea were measured using the visual analog scale (VAS), as well as the frequency of vomiting and the amount of anti-nausea and drug administered at 2, 6, 12, and 24 hours after surgery. Findings: Mean pain score at 2, 6, 12, and 24 hours after surgery was significantly lower in group 1 than other groups (P < 0.05). Postoperative consumption of opioid at 2 and 6 hours after surgery was significantly lower in group 1 than other groups (P < 0.05). The mean score of nausea and anti-emetic consumption were significantly lower in group 2 than other groups (P < 0.05). Conclusion: The combination of three drugs, dexamethasone, ketamine, and fentanyl significantly reduced postoperative pain in patients undergoing laparoscopic cholecystectomy, whereas this effect was only partially attained with the combination of three drugs, metoclopramide, ketamine, and fentanyl. Both combinations of the drugs significantly reduced postoperative nausea and vomiting.http://jims.mui.ac.ir/index.php/jims/article/view/8736Laparoscopic cholecystectomyPostoperative painDexamethasoneMetoclopramideFentanylKetamine |
| spellingShingle | Seyed Morteza Heidari Seyed Jalal Hashemi Farshad Babamir Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy مجله دانشکده پزشکی اصفهان Laparoscopic cholecystectomy Postoperative pain Dexamethasone Metoclopramide Fentanyl Ketamine |
| title | Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy |
| title_full | Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy |
| title_fullStr | Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy |
| title_full_unstemmed | Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy |
| title_short | Comparison of the Effect of Combination of Dexamethasone, Ketamine, and Fentanyl with Combination of Metoclopramide, Ketamine, and Fentanyl on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy |
| title_sort | comparison of the effect of combination of dexamethasone ketamine and fentanyl with combination of metoclopramide ketamine and fentanyl on postoperative pain in patients undergoing laparoscopic cholecystectomy |
| topic | Laparoscopic cholecystectomy Postoperative pain Dexamethasone Metoclopramide Fentanyl Ketamine |
| url | http://jims.mui.ac.ir/index.php/jims/article/view/8736 |
| work_keys_str_mv | AT seyedmortezaheidari comparisonoftheeffectofcombinationofdexamethasoneketamineandfentanylwithcombinationofmetoclopramideketamineandfentanylonpostoperativepaininpatientsundergoinglaparoscopiccholecystectomy AT seyedjalalhashemi comparisonoftheeffectofcombinationofdexamethasoneketamineandfentanylwithcombinationofmetoclopramideketamineandfentanylonpostoperativepaininpatientsundergoinglaparoscopiccholecystectomy AT farshadbabamir comparisonoftheeffectofcombinationofdexamethasoneketamineandfentanylwithcombinationofmetoclopramideketamineandfentanylonpostoperativepaininpatientsundergoinglaparoscopiccholecystectomy |