Ketamine versus Dexmedetomidine Sedation in the Attenuation of Surgical Stress Response and Postoperative Pain: A Retrospective StudyCorrespondence Address :
Dr. Melike Korkmaz Toker,
Mugla Stk Kocman University Training and Research Hospital, Anesthesiology and Reanimation, Mugla, Turkey.
Introduction: Surgical procedures cause stress response in the body. This response involves endocrine, metabolic, haematologic and immunologic reactions. Ketamine has an anti-proinflammatory effect as limiting exacerbation of systemic inflammation. Likewise, dexmedetomidine has anti-stress, sedative, analgesic actions and decreases surgical stress response and leads to better stable haemodynamic properties.
Aim: To compare effects of ketamine, dexmedetomidine and determine correlation between postoperative pain scores and serum C-reactive protein on surgical stress response.
Materials and Methods: Electronic records of 121 patients who had inguinal hernia repair were analysed retrospectively. Patients’ age, sex, operation time, sedation drug, preoperative and postoperative C-Reactive Protein (CRP) and leukocyte levels, postoperative visual analogue scale scores were recorded. Normality of the variables were analysed by Kolmogorov-Smirnov test and homogeneity was analysed by Levene’s test. Mean tests were compared using independent t-test if data distribution was normal or using nonparametric Mann-Whitney U-test if data were not distributed normally. Pearson's correlation was used to analyse correlation between VAS score and postoperative CRP level. The p-value <0.05 was considered statistically significant.
Results: Postoperative mean CRP level was 42.3±9 mg/dL in ketamine group and 65.4±6.6 mg/dL in dexmedetomidine group. Mean visual analogue scale at postoperative 24th hour was 2.6±0.8 in ketamine group and 3±0.7 in dexmedetomidine level. These differences were statistically significant (p<0.05). Leukocyte counts were similar between groups. There was a moderate positive correlation between postoperative 24th hour CRP levels and pain scores.
Conclusion: Ketamine was found to be more effective then dexmedetomidine at attenuation of surgical stress response. Postoperative serum CRP level was correlated with postoperative pain scores.
C-reactive protein, Inguinal hernia, Pain, Sedoanalgesia
Basak Altiparmak, Melke Korkmaz Toker, Ali Ihsan Uysal. KETAMINE VERSUS DEXMEDETOMIDINE SEDATION IN THE ATTENUATION OF SURGICAL STRESS RESPONSE AND POSTOPERATIVE PAIN: A RETROSPECTIVE STUDY. Journal of Clinical and Diagnostic Research [serial online] 2018 June [cited: 2018 Jun 24 ]; 12:UC10-UC12. Available from
Date of Submission: Oct 09, 2017
Date of Peer Review: Dec 06, 2017
Date of Acceptance: Apr 18, 2018
Date of Publishing: Jun 01, 2018
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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