Abstract

GUZMAN MARTINEZ, Juan Karel. Multimodal analgesia with ketamine, dipyrone and tramadol association in emergency surgery. Rev Cub Med Mil [online]. 2014, vol.43, n.2, pp.140-147. ISSN 0138-6557.

Introduction: the postoperative pain is frequent in the patients with affections that require urgency surgery. Its satisfactory treatment constitute one of the most important challenges that we face today. Objective: to compare multimodal analgesia by associating drugs as dipyrone, tramadol, and ketamine with tramadol-dipyrone therapy in patient emergency surgeries. Methods: a randomized prospective, comparative, cross-sectional study was conducted in 100 patients. They were distributed into two groups of 50 each: Group I (control group) had dipyrone 1.2 g plus 100 mg tramadol, diluted in sodium chloride 0.9 %, 200 mL in 20 min intravenously; group II (study group) had dipyrone 1.2 g plus 100 mg tramadol, diluted in sodium chloride 0.9 %, 200 mL in 20 min intravenously. They also received a bolus of ketamine 0.3 mg/kg of patient body weight, followed by continuous infusion of this drug to an infusion rate of 0.8 mg / kg / h to the end of the surgery. Results: the pain intensity was smaller in the study group, thus less rescue analgesia was used, but subjects in the group control that 90 % of the cases needed rescue analgesia. Side effects were nausea and vomiting in group I, and dizziness in group II. No complications occurred in either group.. Conclusions: multimodal analgesia with the association of dipyrone, tramadol, and ketamine turns out to be a superior analgesic method in comparison to dipyrone-tramadol analgesia for controlling postoperative pain in patient emergency surgeries.

Keywords : analgesia; multimodal; ketamina; dipyrone; tramadol; postoperative pain.

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