Eficacia de la ketamina en dosis subanestésicas preoperatorias para el control del dolor postquirúrgico en cirugía laparoscópica abdominal Hospital Regional II del IESS Dr. Teodoro Maldonado Carbo 2010 - 2012
Fecha
2013
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El objetivo de este estudio fue evaluar la eficacia y seguridad de la administración de la Ketamina, en la modalidad de analgesia anticipada parar lograr la disminución del dolor post operatorio en pacientes quirúrgicos sometidos a cirugía laparoscópica con anestesia general en el Hospital Regional 2 IESS “Dr. Teodoro Maldonado Carbo” 2010 -2012. La investigación fue de tipo descriptiva – correlacional y diseño no experimental –- retrospectivo. Resultados se estudiaron 100 adultos entre 18 a 65 años, sometidos a cirugía general laparoscópica con anestesia general, el grupo Ketamina recibió anestesia general + ketamina IV antes de la cirugía y durante ésta y el otro grupo denominado placebo recibió el mismo protocolo de anestesia + placebo. Los pacientes de protocolo ketamina y placebo tuvieron ASA I y II en el 99% y el 1% ASA III sin complicaciones severas. En el grupo ketamina hubo disminución de los requerimientos anestésicos con una media de 0.66 vol. % y el grupo placebo con el 0.86 vol. %. (p0.00). El comportamiento hemodinámico intraoperatorio y postoperatorio fue FC y PA menores dentro del grupo ketamina (sistólica /diastólica, p=0.00). SAT O2 no se aprecian diferencias (p 0.08). La intensidad del dolor en el post operatorio inmediato se encuentran diferencias en los dos grupos en los 120 minutos del post operatorio (p =0.00). Los pacientes del grupo ketamina no necesitaron el uso de fármacos analgésicos en las primeras horas, del grupo placebo 46 pacientes necesitaron la aplicación de una dosis de medicación del dolor de acuerdo al protocolo estándar. Las complicaciones en el grupo ketamina fueron en porcentajes bajos, y algo mayor en el grupo placebo. Conclusión La ketamina en dosis subanestésicas es eficaz al reducir las necesidades de medicación analgésica en las primeras horas después de la intervención quirúrgica. Los efectos adversos son leves o ausentes.
The aim of this study was to evaluate the efficacy and safety of ketamine administration in stop mode preemptive analgesia decreased pain achieve in surgical patients undergoing laparoscopic surgery under general anesthesia at the Hospital Regional 2 IESS “Dr. Teodoro Maldonado Carbo” 2010 -2012. The investigation was descriptive - correlational and nonexperimental design - retrospective. Results were studied 100 adults aged 18-65 years undergoing laparoscopic general surgery with general anesthesia, Ketamine group received general anesthesia + ketamine IV before surgery and during and the other group received placebo called the same anesthetic protocol + placebo. Protocol patients ketamine and placebo were ASA I and II in 99% and 1% ASA III without severe complications. In the group had decreased ketamine anesthetic requirements with an average of 0.66 vol. % and the placebo group with 0.86 vol. %. (p0.00). The intraoperative and postoperative hemodynamic HR and BP was lower in the ketamine group (systolic / diastolic, p = .00). O2 SAT no differences (p .08). The intensity of pain in the immediate postoperative period are differences in the two groups at 120 minutes post-op (p = .00). Ketamine group patients did not require the use of analgesic drugs in the early hours, the placebo group 46 patients required the application of a dose of pain medication according to standard protocol. Complications in the ketamine group were in low percentages, and somewhat higher in the placebo group. Conclusion subanaesthetic dose ketamine is effective to reduce the need for analgesic medications within the first hours after the surgical procedure. The adverse effects are mild or absent.
The aim of this study was to evaluate the efficacy and safety of ketamine administration in stop mode preemptive analgesia decreased pain achieve in surgical patients undergoing laparoscopic surgery under general anesthesia at the Hospital Regional 2 IESS “Dr. Teodoro Maldonado Carbo” 2010 -2012. The investigation was descriptive - correlational and nonexperimental design - retrospective. Results were studied 100 adults aged 18-65 years undergoing laparoscopic general surgery with general anesthesia, Ketamine group received general anesthesia + ketamine IV before surgery and during and the other group received placebo called the same anesthetic protocol + placebo. Protocol patients ketamine and placebo were ASA I and II in 99% and 1% ASA III without severe complications. In the group had decreased ketamine anesthetic requirements with an average of 0.66 vol. % and the placebo group with 0.86 vol. %. (p0.00). The intraoperative and postoperative hemodynamic HR and BP was lower in the ketamine group (systolic / diastolic, p = .00). O2 SAT no differences (p .08). The intensity of pain in the immediate postoperative period are differences in the two groups at 120 minutes post-op (p = .00). Ketamine group patients did not require the use of analgesic drugs in the early hours, the placebo group 46 patients required the application of a dose of pain medication according to standard protocol. Complications in the ketamine group were in low percentages, and somewhat higher in the placebo group. Conclusion subanaesthetic dose ketamine is effective to reduce the need for analgesic medications within the first hours after the surgical procedure. The adverse effects are mild or absent.
Descripción
PDF
Palabras clave
Ketamina, Anestesia general, Dolor postoperatorio, Cirugía abdominal, Laparoscopía, Epidemiología descriptiva, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador