Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2018 | Month : June | Volume : 12 | Issue : 6 | Page : UC10 - UC12

Ketamine versus Dexmedetomidine Sedation in the Attenuation of Surgical Stress Response and Postoperative Pain: A Retrospective Study

Basak Altiparmak, Melke Korkmaz Toker, Ali Ihsan Uysal

1. Assistant Professor, Department of Anesthesiology and Reanimation, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey. 2. Medical Doctor, Department of Anesthesiology, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey. 3. Medical Doctor, Department of Anesthesiology and Reanimation, Mugla Sitki Kocman University Training and Research Hospital, Mugla, Turkey.

Correspondence Address :
Dr. Melike Korkmaz Toker,
Mugla Stk Kocman University Training and Research Hospital, Anesthesiology and Reanimation, Mugla, Turkey.
E-mail: meltoker@gmail.com

Abstract

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.

Keywords

C-reactive protein, Inguinal hernia, Pain, Sedoanalgesia

How to cite this article :

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
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2018&month=June&volume=12&issue=6&page=UC10-UC12&id=11657

DOI and Others

DOI: 10.7860/JCDR/2018/34139.11657

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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