Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Analgesic effect and safety of postoperative low-dose ketamine/midazolam combination vis-à-vis dexmedetomidine in non-cardiac surgery

Weiwei Zhan , Yuanyuan Zheng, Chunmei Xu², Fang Wang, Xiangyu Wang

Department of Anesthesiology, The Third Clinical Medical College of China Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang 443002, Hubei, China;

For correspondence:- Weiwei Zhan Email: GraceMandeliPjPo@gmail.com Tel:+8613617178509

Accepted: 20 October 2020 Published: 30 November 2020

Citation: Zhan W, Zheng Y, Xu C, Wang F, Wang X. Analgesic effect and safety of postoperative low-dose ketamine/midazolam combination vis-à-vis dexmedetomidine in non-cardiac surgery. Trop J Pharm Res 2020; 19(11):2453-2460 doi: 10.4314/tjpr.v19i11.29

© 2020 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To compare the analgesic efficacy and safety of use of postoperative low-dose parenteral ketamine/midazolam combination, and postoperative parenteral dexmedetomidine in major non-cardiac surgeries.

Methods: Major non-cardiac surgeries were performed in patients under propofol/morphine anesthesia. After the surgeries, patients received low-dose of ketamine with midazolam (KM cohort, n = 115), dexmedetomidine (DEX cohort, n = 112), or paracetamol infusion (PL cohort, n = 148). When visual analog scale score was > 4 in a resting condition, 3 mg bolus intravenous morphine was administered. Data for total morphine requirements and treatment-emergent adverse effects (within 2 days of post-operative treatment) were collected and analyzed.

Results: Thirty-eight patients from KM cohort, 55 patients from DEX cohort, and 109 patients from PL cohort required 3 mg bolus intravenous morphine for postoperative pain management. Patients from KM cohort had nausea, vomiting, blurred vision, dizziness, and hallucinations, while patients in DEX cohort experienced headache and bradycardia post-surgery. Patients in PL cohort reported drossiness, constipation, urinary retention, and dry mouth.

Conclusion: Postoperative low doses of ketamine + midazolam and dexmedetomidine are effective for postoperative pain management, and they produce low adverse effects.

Keywords: Bradycardia, Dexmedetomidine, Hallucinations, Ketamine, Midazolam, Postoperative pain