Effect of Ketamine plus Dexamethasone on postoperative epidural analgesia in patients with esophageal cancer
WANG Qionghua1 FANG Yanhong1 XU Binbing2
1.Department of Anesthesiology, Jiangjin Central Hospital, Chongqing 402260, China;
2.Department of Anesthesiology, Suining Central Hospital, Sichuan Province, Suining 629000, China
Abstract：Objective To observe the effect of single and small dose of Ketamine combined with Dexamethasone on postoperative epidural analgesia in patients with esophageal cancer with single-lung ventilation. Methods Sixty patients undergoing esophageal cancer surgery with single-lung ventilation in the Department of Thoracic Surgery of Suining Central Hospital were selected. The patients collected from December 2016 to July 2017 were randomly divided into blank control group (S group), Ketamine group (K group), Dexamethasone group (D group) and Ketamine plus Dexamethasone group (KD group) according to random number table method. Preoperative epidural puncture and catheterization. Ketamine 0.5 mg/kg (K group), Dexamethasone 10 mg (D group), Ketamine 0.5 mg/kg + Dexamethasone 10 mg (KD group), 10 mL of normal saline (S group) were administered 15 minutes before induction of general anesthesia, and the four groups were diluted to 10 mL with physiological saline. Intraoperative single-lung ventilation, operation time, postoperative analgesia scores in 48 h, self-controlled analgesic compression times, total dosage of analgesics by patient-controlled epidural analgesia (PCEA) and postoperative adverse reactions of the four groups were all recorded. Results No significant difference in ventilation time and operation time was identified among the four groups (P ＞ 0.05). Compared with K group, D group and S group, the visual analogue score (VAS) and Prince-Henry score of postoperative analgesia in KD group were lower within 24 h (P ＜ 0.05). But no significant difference in VAS score and Prince-Henry score was identified at 48 h among four groups (P ＞ 0.05). The number of compression times and the total dosage of analgesics were less, the rate of nausea and vomiting was lower in KD group compared with group D, group S and group K (P ＜ 0.05). The rate of postoperative delirium was not significantly different among four groups (P ＞ 0.05). Conclusion The prophylactic use of Ketamine plus Dexamethasone before surgery can effectively increase the analgesic effect of PCEA in 24 h after surgery and reduce the dosage of analgesic drugs and postoperative adverse reactions.
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2019, Vol. 16 
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