Preemptive Use of Diclofenac in Combination With Ketamine in Patients Undergoing Laparoscopic Cholecystectomy

Nesek-Adam, Višnja; Grizelj-Stojčić, Elvira; Mršić, Viviana; Rašić, Žarko; Schwarz, Dragan

doi:10.1097/sle.0b013e31824f8ae4

Cited by 20 publications

(17 citation statements)

References 28 publications

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“…Nesek-Adam et al 20 found the ketamine can decreased the postoperative pain at 12 h postoperatively in abdomen while the postoperative pain score during 12 -24 h postoperatively was higher in ketamine group than that in control group. These study results of Nesek-Adam et al 20 were all no statistically significant. Lenzmeier et al 19 and Reza et al 13 assessed the postoperative pain scores of ketamine at a dosage of 0.50 mg/kg.…”

Section: Postoperative Pain Scorementioning

confidence: 99%

“…According to inclusion criteria in our analysis, a total of five English studies 13,[17][18][19][20] matched the selection criteria finally (Figure 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…Kwok et al 18 and Nesek-Adam et al 20 accessed the postoperative pain score of ketamine at a dosage of 0.15 mg/kg.…”

Section: Postoperative Pain Scorementioning

confidence: 99%

“…The publication year of studies ranged from 2000 to 2012. The studies respectively come from Asian 13,18 , Europe 19,20 and America 17 . Total 266 patients (including 139 patients in ketamine group and 127 patients in control group) were included in this meta-analysis.…”

Section: Characteristic Of Included Studiesmentioning

confidence: 99%

“…The surgeries in the included studies were all abdominal surgery. Visual analog scale (VAS) and verbal rating scale (VRS) were used to evaluate pain in two included studies 17,20 , while the pain was accessed only based on the VAS in the other three studies 13,18,19 . The range dosage of ketamine was 0.15 -0.5 mg/kg.…”

Section: Characteristic Of Included Studiesmentioning

confidence: 99%

See 4 more Smart Citations

Preemptive analgesia effects of Ketamine in patients undergoing surgery. A meta-analysis

Yang¹,

Zhang²,

Zhang³

et al. 2014

Acta Cir. Bras.

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Section: Postoperative Pain Scorementioning

confidence: 99%

“…According to inclusion criteria in our analysis, a total of five English studies 13,[17][18][19][20] matched the selection criteria finally (Figure 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…Kwok et al 18 and Nesek-Adam et al 20 accessed the postoperative pain score of ketamine at a dosage of 0.15 mg/kg.…”

Section: Postoperative Pain Scorementioning

confidence: 99%

Section: Characteristic Of Included Studiesmentioning

confidence: 99%

Section: Characteristic Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Preemptive analgesia effects of Ketamine in patients undergoing surgery. A meta-analysis

Yang¹,

Zhang²,

Zhang³

et al. 2014

Acta Cir. Bras.

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show abstract

Pharmacological interventions for prevention or treatment of postoperative pain in people undergoing laparoscopic cholecystectomy

Gurusamy

Vaughan

Toon³

et al. 2014

Cochrane Database of Systematic Reviews

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Perioperative intravenous ketamine for acute postoperative pain in adults

Brinck

Tiippana

Heesen

et al. 2018

CDSR

180

134

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Data collection and analysis Two review authors searched for studies, extracted efficacy and adverse event data, examined issues of study quality and potential bias, and performed analyses. Primary outcomes were opioid consumption and pain intensity at rest and during movement at 24 and 48 hours postoperatively. Secondary outcomes were time to first analgesic request, assessment of postoperative hyperalgesia, central nervous system (CNS) adverse effects, and postoperative nausea and vomiting. We assessed the evidence using GRADE and created a 'Summary of findings' table. Main results We included 130 studies with 8341 participants. Ketamine was given to 4588 participants and 3753 participants served as controls. Types of surgery included ear, nose or throat surgery, wisdom tooth extraction, thoracotomy, lumbar fusion surgery, microdiscectomy, hip joint replacement surgery, knee joint replacement surgery, anterior cruciate ligament repair, knee arthroscopy, mastectomy, haemorrhoidectomy, abdominal surgery, radical prostatectomy, thyroid surgery, elective caesarean section, and laparoscopic surgery. Racemic ketamine bolus doses were predominantly 0.25 mg to 1 mg, and infusions 2 to 5 µg/kg/minute; 10 studies used only S-ketamine and one only R-ketamine. Risk of bias was generally low or uncertain, except for study size; most had fewer than 50 participants per treatment arm, resulting in high heterogeneity, as expected, for most analyses. We did not stratify the main analysis by type of surgery or any other factor, such as dose or timing of ketamine administration, and used a non-stratified analysis. Perioperative intravenous ketamine reduced postoperative opioid consumption over 24 hours by 8 mg morphine equivalents (95% CI 6 to 9; 19% from 42 mg consumed by participants given placebo, moderate-quality evidence; 65 studies, 4004 participants). Over 48 hours, opioid consumption was 13 mg lower (95% CI 10 to 15; 19% from 67 mg with placebo, moderate-quality evidence; 37 studies, 2449 participants). Perioperative intravenous ketamine reduced pain at rest at 24 hours by 5/100 mm on a visual analogue scale (95% CI 4 to 7; 19% lower from 26/100 mm with placebo, high-quality evidence; 82 studies, 5004 participants), and at 48 hours by 5/100 mm (95% CI 3 to 7; 22% lower from 23/100 mm, high-quality evidence; 49 studies, 2962 participants). Pain during movement was reduced at 24 hours (6/100 mm, 14% lower from 42/100 mm, moderate-quality evidence; 29 studies, 1806 participants), and 48 hours (6/100 mm, 16% lower from 37 mm, low-quality evidence; 23 studies, 1353 participants). Results for primary outcomes were consistent when analysed by pain at rest or on movement, operation type, and timing of administration, or sensitivity to study size and pain intensity. No analysis by dose was possible. There was no difference when nitrous oxide was used. We downgraded the quality of the evidence once if numbers of participants were large but small-study effects were present, or twice if numbers were small and small-study effects likel...

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Preemptive Use of Diclofenac in Combination With Ketamine in Patients Undergoing Laparoscopic Cholecystectomy

Abstract: The preemptive administration of a combination of low-dose ketamine plus diclofenac sodium improved postoperative analgesia after laparoscopic cholecystectomy, whereas ketamine at a dose of 0.15 mg/kg did not elicit a preemptive analgesic effect.

Cited by 20 publications

References 28 publications

Preemptive analgesia effects of Ketamine in patients undergoing surgery. A meta-analysis

Preemptive analgesia effects of Ketamine in patients undergoing surgery. A meta-analysis

Pharmacological interventions for prevention or treatment of postoperative pain in people undergoing laparoscopic cholecystectomy

Perioperative intravenous ketamine for acute postoperative pain in adults

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