Assessment of Analgesic Effect of Ketamine Vs Ketamine Magnesium Infusion and Their Effect on Postoperative Morphine Consumption after Surgical Nephrectomy

Abstract

Two non-opioid analgesics such as ketamine and magnesium have been investigated for their potential use as adjuvants for opioid analgesics. They were shown to have anaesthetic and analgesic qualities, and it has been proposed that they may have a role in reducing the need for analgesic medication through the post-operative time. Aim and Objectives: Primarily, we compare intra and postoperative analgesic effect of ketamine versus ketamine magnesium infusion and their influence on postoperative morphine consumption after nephrectomy and secondarily to assess hemodynamic changes and intensity of pain Methods: This study was conducted in Six October University Hospital, 100 patients presented for elective nephrectomy under general anesthesia in the Department of Anesthesiology were randomly assigned in this prospective double blinded study into one of the two groups using computer generated table. All participants got oral midazolam 0.1 mg/kg in the evening before surgery, ketamine participants (Group I): intravenously injected by ketamine bolus dose (0.3 mg/kg), followed by continued ketamine infusion (0.15 mg/kg/h), Ketamine Magnesium participants (Group II): injected by a bolus dose of magnesium (50 mg/kg) + ketamine (0.3 mg/kg) intravenously, then by continuous infusion of (0.15 mg/kg/h) of ketamine + (10 mg/kg/h) of magnesium sulphate. Following the procedure, VAS score, Ramsay sedation scale, total rescue analgesic doses of morphine taken postoperatively, and unfavorable complications like nausea and vomiting were all documented. Results: There were statistically significant differences between the two groups in post-operative VAS score, Ramsay Sedation Scale, and hemodynamic changes it was better in group II. Postoperative morphine consumption was remarkably decreased in collection II, with fewer side-effects. Conclusion: Magnesium sulphate and ketamine together are more effective in curing the postoperative pain and maintaining patient hemodynamics while reducing narcotic side effects.