Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain

Introduction: Post-operative pain reduction is one of the problems in the patients with preoperative narcotic dependency. Morphine is the most common drugs to control postoperative pain. Due to resistance to morphine and  its side effects in addict patients, using of adjuvant drugs such as...

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Main Authors: najmeh najafi, Habibollah Hosseini, Maryam Hatami, Mahmmod vakili, Farzaneh Shishebor, Mohammad Zamanian, Elham Hakimizadeh
Format: Article
Language:fas
Published: Shahid Sadoughi University of Medical Sciences 2018-06-01
Series:Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd
Subjects:
Online Access:http://jssu.ssu.ac.ir/browse.php?a_code=A-10-3460-1&slc_lang=en&sid=1
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author najmeh najafi
Habibollah Hosseini
Maryam Hatami
Mahmmod vakili
Farzaneh Shishebor
Mohammad Zamanian
Elham Hakimizadeh
author_facet najmeh najafi
Habibollah Hosseini
Maryam Hatami
Mahmmod vakili
Farzaneh Shishebor
Mohammad Zamanian
Elham Hakimizadeh
author_sort najmeh najafi
collection DOAJ
description Introduction: Post-operative pain reduction is one of the problems in the patients with preoperative narcotic dependency. Morphine is the most common drugs to control postoperative pain. Due to resistance to morphine and  its side effects in addict patients, using of adjuvant drugs such as ketamine has increased. The aim of this study was to evaluate the effect of adding ketamine to morphine in patients addicted to opioid with post orthopedic operation pain. Methods: In a double blind clinical trial, 60 patients undergoing orthopedic operation with history of opioid consumption were randomly divided in 2 groups. Post operation, the first group received morphine 20 mg and the second group received morphine 20 mg + ketamine 100 mg via IV patient-controlled analgesia (IPCA). The pain score as visual analogue scale (VAS), sedation score, and nausea and vomiting were evaluated at 1, 6, 12 and 24 hours post operation. SPSS v.20 was used for data analysis. Results: Results showed that dose of morphine consumption in morphine group was significantly increased compared to the morphine + ketamine group (p ˂ 0.001). In addition, only at 12 hours after surgery the mean of pain score in the morphine group was significantly reduced compared to the second group (p = 0.02). The mean of sedation score at 1 (p ˂ 0.001), 6 (p = 0.002), 12 (p = 0.001) and 24 (p ˂ 0.001) hours after surgery in the morphine group was increased compared to the other group. At 1 hour, the mean of nausea and vomiting scores in the morphine group was significantly reduced compared to the morphine + ketamine group (p = 0.024). Conclusion: Addition of ketamine to morphine in the patients with history of opioid consumption reduced using of the morphine. But had no effect on pain and sedation score reduction.
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spelling doaj.art-ec289be509bf4cf3867d79b24f08160b2022-12-22T00:17:28ZfasShahid Sadoughi University of Medical SciencesMajallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd2228-57412228-57332018-06-01263257265Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation painnajmeh najafi0Habibollah Hosseini1Maryam Hatami2Mahmmod vakili3Farzaneh Shishebor4Mohammad Zamanian5Elham Hakimizadeh6 Department of Anesthesiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd. Department of Anesthesiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd. Department of Anesthesiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd. Department of Social Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd. Department of Anesthesiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd. Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan. Physiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan. Introduction: Post-operative pain reduction is one of the problems in the patients with preoperative narcotic dependency. Morphine is the most common drugs to control postoperative pain. Due to resistance to morphine and  its side effects in addict patients, using of adjuvant drugs such as ketamine has increased. The aim of this study was to evaluate the effect of adding ketamine to morphine in patients addicted to opioid with post orthopedic operation pain. Methods: In a double blind clinical trial, 60 patients undergoing orthopedic operation with history of opioid consumption were randomly divided in 2 groups. Post operation, the first group received morphine 20 mg and the second group received morphine 20 mg + ketamine 100 mg via IV patient-controlled analgesia (IPCA). The pain score as visual analogue scale (VAS), sedation score, and nausea and vomiting were evaluated at 1, 6, 12 and 24 hours post operation. SPSS v.20 was used for data analysis. Results: Results showed that dose of morphine consumption in morphine group was significantly increased compared to the morphine + ketamine group (p ˂ 0.001). In addition, only at 12 hours after surgery the mean of pain score in the morphine group was significantly reduced compared to the second group (p = 0.02). The mean of sedation score at 1 (p ˂ 0.001), 6 (p = 0.002), 12 (p = 0.001) and 24 (p ˂ 0.001) hours after surgery in the morphine group was increased compared to the other group. At 1 hour, the mean of nausea and vomiting scores in the morphine group was significantly reduced compared to the morphine + ketamine group (p = 0.024). Conclusion: Addition of ketamine to morphine in the patients with history of opioid consumption reduced using of the morphine. But had no effect on pain and sedation score reduction.http://jssu.ssu.ac.ir/browse.php?a_code=A-10-3460-1&slc_lang=en&sid=1Post-operative pain Orthopedic operation IV patient-controlled analgesia Morphine Ketamine Addiction
spellingShingle najmeh najafi
Habibollah Hosseini
Maryam Hatami
Mahmmod vakili
Farzaneh Shishebor
Mohammad Zamanian
Elham Hakimizadeh
Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd
Post-operative pain
Orthopedic operation
IV patient-controlled analgesia
Morphine
Ketamine
Addiction
title Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
title_full Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
title_fullStr Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
title_full_unstemmed Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
title_short Effect of adding Ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
title_sort effect of adding ketamine to the morphine in patients addicted to opioid post orthopedic operation pain
topic Post-operative pain
Orthopedic operation
IV patient-controlled analgesia
Morphine
Ketamine
Addiction
url http://jssu.ssu.ac.ir/browse.php?a_code=A-10-3460-1&slc_lang=en&sid=1
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