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Effects of low-dose ketamine on succinylcholine-induced postoperative myalgia in outpatient surgeries: a randomized, double-blind study.

Nasseri K, Arvien S - J Pain Res (2016)

Bottom Line: Overall, the incidence of POM in Group K was significantly less, when compared with Group N (P<0.05), but both groups were comparable based on the grade 2 of POM.After the induction of anesthesia, the systolic and diastolic blood pressure values were found to reduce in both groups (P<0.05).The addition of 0.5 mg/kg of ketamine to propofol for the induction of anesthesia can be effective in reducing the incidence of low-grade POM.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia and Intensive Care, Social Determinants of Health Research Center.

ABSTRACT

Objective: Despite the many complications of succinylcholine, it is still widely used as a superior muscle relaxant for rapid sequence induction. One of these complications is postoperative myalgia (POM). The aim of this study was to investigate the prophylactic effect of low-dose ketamine on the incidence and severity of POM.

Materials and methods: In this double-blind clinical study, a total of 148 patients scheduled for general anesthesia were randomly divided into two equal groups. Initially, in Group K, 0.5 mg/kg of ketamine was injected intravenously, whereas in Group N, the same volume (5 mL) of normal saline was injected. Thereafter, anesthesia was induced in all patients, by injecting 1.5 mg/kg of fentanyl and 2 mg/kg of propofol intravenously. Following the loss of eyelid reflex, 1.5 mg/kg of succinylcholine was injected intravenously as a muscle relaxant and then the patients were intubated. POM was defined as a pain with no surgical interferences, and its intensity was graded based on a four-point scale. The incidence and severity of myalgia were assessed by a blinded observer 24 hours after surgery.

Results: In terms of demographic data, the results of this study showed that there is no significant difference between patients in both groups (P>0.05). Overall, the incidence of POM in Group K was significantly less, when compared with Group N (P<0.05), but both groups were comparable based on the grade 2 of POM. After the induction of anesthesia, the systolic and diastolic blood pressure values were found to reduce in both groups (P<0.05). However, the changes were somehow similar, and repeated measures of variance analysis showed no significant difference in the two study groups (P>0.05).

Conclusion: The addition of 0.5 mg/kg of ketamine to propofol for the induction of anesthesia can be effective in reducing the incidence of low-grade POM.

No MeSH data available.


Related in: MedlinePlus

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Mentions: In this study, a total of 207 patients were scheduled for outpatient surgery from July 2013 to August 2014. Of them, 29 patients could not meet the entry criteria. Twenty-seven patients had no willingness to participate in the study, and the surgery of three patients was canceled. The remaining 148 patients were randomly assigned into two groups. Two patients in Group N due to nausea, vomiting, and pain and one patient in Group K due to arrhythmia were turned from outpatient to inpatient. Two persons from Group K did not cooperate with the evaluation of POM. The data associated with the 72 patients in Group N and 71 patients in Group K were analyzed (Figure 1).


Effects of low-dose ketamine on succinylcholine-induced postoperative myalgia in outpatient surgeries: a randomized, double-blind study.

Nasseri K, Arvien S - J Pain Res (2016)

Flow diagram.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940009&req=5

f1-jpr-9-503: Flow diagram.
Mentions: In this study, a total of 207 patients were scheduled for outpatient surgery from July 2013 to August 2014. Of them, 29 patients could not meet the entry criteria. Twenty-seven patients had no willingness to participate in the study, and the surgery of three patients was canceled. The remaining 148 patients were randomly assigned into two groups. Two patients in Group N due to nausea, vomiting, and pain and one patient in Group K due to arrhythmia were turned from outpatient to inpatient. Two persons from Group K did not cooperate with the evaluation of POM. The data associated with the 72 patients in Group N and 71 patients in Group K were analyzed (Figure 1).

Bottom Line: Overall, the incidence of POM in Group K was significantly less, when compared with Group N (P<0.05), but both groups were comparable based on the grade 2 of POM.After the induction of anesthesia, the systolic and diastolic blood pressure values were found to reduce in both groups (P<0.05).The addition of 0.5 mg/kg of ketamine to propofol for the induction of anesthesia can be effective in reducing the incidence of low-grade POM.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia and Intensive Care, Social Determinants of Health Research Center.

ABSTRACT

Objective: Despite the many complications of succinylcholine, it is still widely used as a superior muscle relaxant for rapid sequence induction. One of these complications is postoperative myalgia (POM). The aim of this study was to investigate the prophylactic effect of low-dose ketamine on the incidence and severity of POM.

Materials and methods: In this double-blind clinical study, a total of 148 patients scheduled for general anesthesia were randomly divided into two equal groups. Initially, in Group K, 0.5 mg/kg of ketamine was injected intravenously, whereas in Group N, the same volume (5 mL) of normal saline was injected. Thereafter, anesthesia was induced in all patients, by injecting 1.5 mg/kg of fentanyl and 2 mg/kg of propofol intravenously. Following the loss of eyelid reflex, 1.5 mg/kg of succinylcholine was injected intravenously as a muscle relaxant and then the patients were intubated. POM was defined as a pain with no surgical interferences, and its intensity was graded based on a four-point scale. The incidence and severity of myalgia were assessed by a blinded observer 24 hours after surgery.

Results: In terms of demographic data, the results of this study showed that there is no significant difference between patients in both groups (P>0.05). Overall, the incidence of POM in Group K was significantly less, when compared with Group N (P<0.05), but both groups were comparable based on the grade 2 of POM. After the induction of anesthesia, the systolic and diastolic blood pressure values were found to reduce in both groups (P<0.05). However, the changes were somehow similar, and repeated measures of variance analysis showed no significant difference in the two study groups (P>0.05).

Conclusion: The addition of 0.5 mg/kg of ketamine to propofol for the induction of anesthesia can be effective in reducing the incidence of low-grade POM.

No MeSH data available.


Related in: MedlinePlus