Analgesia for the Change of Dressing in Burn Victims: A Comparison Between Oral Ketamine and Oral Dexmedetomidine

Esculapio Pub Date : 2021-03-31 DOI:10.51273/ESC21.251718
Faridah Sohail, Lala Rukh Bangash, W. Azim, F. Arshad, A. Anwar, A. Niazi
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Abstract

Objective: To compare the efficacy of oral ketamine with oral dexmedetomidine for providing adequate analgesia for change of dressing in burn patients in burn dressing room. Methods: This randomized controlled trial was carried out in Jinnah Burn and Reconstructive Surgery Center, Lahore, from April 2019 to September 2019 after getting the approval from the Ethical Committee of Jinnah Hospital / Allama Iqbal Medical College, Lahore. 80 patients between 20 to 50 years, with 1st and 2nd degree burns and 20 to 40% of total body surface area involved were allocated in two groups A and B. The patients in group A received oral ketamine at a dose of 5mg/kg in 15 ml of water 30 mins while those in group B received dexmedetomidine, 4 ug/kg orally, in 15 ml of water 30 mins before the start of dressing change. The change of dressing was carried out with continuous vital monitoring. Pain was assessed via visual analogue scale (VAS) and sedation via Ramsay sedation score. All the observations were recorded on the predesigned proforma. SPSS version 21 was used for data analysis. Result: The baseline mean VAS score of patients in group A was 7.67 + 0.55 and in group B was 7.70 + 0.57 (p value = 0.799). Significant decrease in pain score in both groups was noted after 30 mins of drugs administration (p=0.000). Also a significant difference in pain scores was seen between the two groups (p< 0.05), with the patients in group A having lower pain scores as compared to patients in group B. Conclusion: both ketamine and dexmedetomidine provide adequate analgesia for the change of burn dressing when administered orally with ketamine providing better analgesic state as compared to dexmedetomidine. Key Words: Burn, ketamine, dexmedetomidine, analgesia. How to cite: Sohail F., Bangash R.L., Azim W., Arshad F, Anwar A., Niazi K.A. Analgesia for the Change of Dressing in Burn Victims: A Comparison between Oral Ketamine and Oral Dexmedetomidine. Esulapio 2021;17(01):39-44
烧伤患者换药镇痛:口服氯胺酮与口服右美托咪定的比较
目的:比较口服氯胺酮与口服右美托咪定在烧伤换药室为烧伤患者提供充足镇痛的效果。方法:经拉合尔真纳医院/阿拉玛伊克巴尔医学院伦理委员会批准,本随机对照试验于2019年4月至2019年9月在拉合尔真纳烧伤和重建手术中心进行。1、2度烧伤,烧伤面积占体表总面积的20% ~ 40%,分为A、B两组。A组患者在换药前30分钟口服氯胺酮,剂量为5mg/kg, 15ml水中,B组患者口服右美托咪定,剂量为4 ug/kg, 15ml水中,30分钟。换药时进行连续生命监测。采用视觉模拟评分(VAS)评定疼痛,采用Ramsay镇静评分评定镇静程度。所有的观察结果都记录在预先设计的表格上。使用SPSS version 21进行数据分析。结果:A组患者基线平均VAS评分为7.67 + 0.55,B组患者基线平均VAS评分为7.70 + 0.57 (p值= 0.799)。两组患者给药30 min后疼痛评分均显著降低(p=0.000)。两组患者的疼痛评分也有显著差异(p< 0.05), a组患者的疼痛评分低于b组患者。结论:氯胺酮和右美托咪定口服给药对烧伤敷料的改变都有足够的镇痛作用,氯胺酮的镇痛状态优于右美托咪定。关键词:烧伤,氯胺酮,右美托咪定,镇痛。引用本文:Sohail F, Bangash R.L, Azim W, Arshad F, Anwar A, Niazi k.a。口服氯胺酮与口服右美托咪定对烧伤患者换药镇痛效果的比较。Esulapio 2021; 17 (01): 39-44
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