| Objective To study the effect of low-dose ketamine on opioid-inducehyperalgesia(OIH) after remifentanil anesthesia in escharectomy and skin grafting forburn patients.Methods: Sixty patients undergoing burn escharectomy and skin grafting surgeryadmitted to The First Hospital Affiliated to the Chinese PLA General Hospital fromJune2013to December2013were enrolled in this study. All patients aged18-60years,ASA â… -â…¡, recipient area1%-30%, were randomly allocated into two groups,30casesin each group. Anesthesia was equally maintained with sevofurane and4-8ng/ml ofremifentanil in all patients. In the ketamine group (n=30), ketamine was injected0.3mg/kg at the beginning of induction and followed with a continuous dosage of3μg/(kg.min), while the control group (n=30) was injected and infused with an equalamount of0.9%sodium chloride injection. We compared patients’ vital signs and Bisindex score during operation, postoperative VAS(visual analogue scale/Score) up to7hours and morphine demand through patient controlled analgesia (PCA).Results: During the operation, low dose ketamine dose not affect the vital signs ofpatients，but that allow Bis score to rise during the former20min and then decreasedgradually when compared with the control group; Ketamine group3h postoperativeVAS score was lower than that of the control group (P<0.05); Ketamine group PCAmorphine consumption was lower than the control group in the first2h afteroperation(P<0.05); Ketamine group patients has no hallucination or nightmarephenomenon.Conclusions: Continuous infusion of low dose ketamine can decrease degree ofearly opioid-induce hyperalgesia induced by remifentanil and the consumption ofopioids during patient controlled analgesia after burn escharectomy and skin graftingsurgery. The dosage of ketamine used has not induce hallucination or nightmare phenomenon in those patients. |
