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The effect of local injections of bupivacaine plus ketamine, bupivacaine alone, and placebo on reducing postoperative anal fistula pain: a randomized clinical trial.

Kazemeini A, Rahimi M, Fazeli MS, Mirjafari SA, Ghaderi H, Fani K, Forozeshfard M, Matin M - ScientificWorldJournal (2014)

Bottom Line: Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (P < 0.001).Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (P < 0.05).Local anesthesia (1 mL of ketamine plus 2 mL of bupivacaine 0.5% or 1 mL of normal saline plus 2 mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background and objective: This study aimed to compare the effects of different local anesthetic solutions on postoperative pain of anal surgery in adult patients.

Method: In this randomized double-blind prospective clinical trial, 60 adult patients (18 to 60 years old) with physical status class I and class II that had been brought to a university hospital operating room for fistula anal surgery with spinal anesthesia were selected. Patients were randomly divided into 4 equal groups according to table of random numbers (created by Random Allocation Software 1). Group 1 received 3 mL of normal saline, group 2, 1 mL of normal saline plus 2 mL of bupivacaine 0.5%, group 3, 1 mL of ketamine plus 2 mL of bupivacaine 0.5%, and group 4, no infiltration. Intensity of pain in patients was measured using visual analogue scale (VAS) at 0 (transfer to ward), 2, 6, 12, and 24 hours after surgery. Time interval to administration of drugs and overall dose of drugs were measured in 4 groups.

Results: Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (P < 0.001). Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (P < 0.05).

Conclusion: Local anesthesia (1 mL of ketamine plus 2 mL of bupivacaine 0.5% or 1 mL of normal saline plus 2 mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.

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Related in: MedlinePlus

Level of pain at different times after surgery for separate groups. ANOVA test was used to compare groups. There was a significant difference in pain intensity between groups. Level of pain significantly increased and then decreased. There was an insignificant difference in pain intensity between groups 2 and 3. However, there was a significant difference between groups 2 and 3 and 1 and 4 (P < 0.001). Group 1 (3 mL of normal saline), group 2 (1 mL of normal saline plus 2 mL of bupivacaine 0.5%), group 3 (1 mL of ketamine plus 2 mL of bupivacaine 0.5%), and group 4 (no infiltration).
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fig1: Level of pain at different times after surgery for separate groups. ANOVA test was used to compare groups. There was a significant difference in pain intensity between groups. Level of pain significantly increased and then decreased. There was an insignificant difference in pain intensity between groups 2 and 3. However, there was a significant difference between groups 2 and 3 and 1 and 4 (P < 0.001). Group 1 (3 mL of normal saline), group 2 (1 mL of normal saline plus 2 mL of bupivacaine 0.5%), group 3 (1 mL of ketamine plus 2 mL of bupivacaine 0.5%), and group 4 (no infiltration).

Mentions: There were significant differences between groups in pain assessment times (P < 0.001, using ANOVA), as shown in Table 3 and Figure 1, for different groups and assessment times.


The effect of local injections of bupivacaine plus ketamine, bupivacaine alone, and placebo on reducing postoperative anal fistula pain: a randomized clinical trial.

Kazemeini A, Rahimi M, Fazeli MS, Mirjafari SA, Ghaderi H, Fani K, Forozeshfard M, Matin M - ScientificWorldJournal (2014)

Level of pain at different times after surgery for separate groups. ANOVA test was used to compare groups. There was a significant difference in pain intensity between groups. Level of pain significantly increased and then decreased. There was an insignificant difference in pain intensity between groups 2 and 3. However, there was a significant difference between groups 2 and 3 and 1 and 4 (P < 0.001). Group 1 (3 mL of normal saline), group 2 (1 mL of normal saline plus 2 mL of bupivacaine 0.5%), group 3 (1 mL of ketamine plus 2 mL of bupivacaine 0.5%), and group 4 (no infiltration).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4269080&req=5

fig1: Level of pain at different times after surgery for separate groups. ANOVA test was used to compare groups. There was a significant difference in pain intensity between groups. Level of pain significantly increased and then decreased. There was an insignificant difference in pain intensity between groups 2 and 3. However, there was a significant difference between groups 2 and 3 and 1 and 4 (P < 0.001). Group 1 (3 mL of normal saline), group 2 (1 mL of normal saline plus 2 mL of bupivacaine 0.5%), group 3 (1 mL of ketamine plus 2 mL of bupivacaine 0.5%), and group 4 (no infiltration).
Mentions: There were significant differences between groups in pain assessment times (P < 0.001, using ANOVA), as shown in Table 3 and Figure 1, for different groups and assessment times.

Bottom Line: Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (P < 0.001).Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (P < 0.05).Local anesthesia (1 mL of ketamine plus 2 mL of bupivacaine 0.5% or 1 mL of normal saline plus 2 mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background and objective: This study aimed to compare the effects of different local anesthetic solutions on postoperative pain of anal surgery in adult patients.

Method: In this randomized double-blind prospective clinical trial, 60 adult patients (18 to 60 years old) with physical status class I and class II that had been brought to a university hospital operating room for fistula anal surgery with spinal anesthesia were selected. Patients were randomly divided into 4 equal groups according to table of random numbers (created by Random Allocation Software 1). Group 1 received 3 mL of normal saline, group 2, 1 mL of normal saline plus 2 mL of bupivacaine 0.5%, group 3, 1 mL of ketamine plus 2 mL of bupivacaine 0.5%, and group 4, no infiltration. Intensity of pain in patients was measured using visual analogue scale (VAS) at 0 (transfer to ward), 2, 6, 12, and 24 hours after surgery. Time interval to administration of drugs and overall dose of drugs were measured in 4 groups.

Results: Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (P < 0.001). Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (P < 0.05).

Conclusion: Local anesthesia (1 mL of ketamine plus 2 mL of bupivacaine 0.5% or 1 mL of normal saline plus 2 mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.

Show MeSH
Related in: MedlinePlus