Comparison of Ketamine, Dexmedetomidine and Lidocaine in Multimodal Analgesia Management Following Sleeve Gastrectomy Surgery: A Randomized Double-Blind Trial

• Published in: Journal of perianesthesia nursing Vol. 37; no. 6; pp. 820 - 826
• Main Authors: Ustun, Yasemin Burcu, Turunc, Esra, Ozbalci, Gokhan Selcuk, Dost, Burhan, Bilgin, Sezgin, Koksal, Ersin, Kaya, Cengiz
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: Analgesia; Anesthetics, Local; dexmedetomidine; Dexmedetomidine - therapeutic use; Double-Blind Method; Gastrectomy; Humans; Ketamine; lidocaine; Lidocaine - therapeutic use; obesity, morbid; pain, postoperative; Pain, Postoperative - drug therapy; Prospective Studies; dexmedetomidine; ketamine; obesity, morbid; lidocaine; pain, postoperative
• ISSN: 1089-9472; 1532-8473
• DOI: 10.1016/j.jopan.2021.12.012

The aim of this study was to compare the effects of ketamine, dexmedetomidine, and lidocaine infusions added to the multimodal analgesia regimen on pain scores and analgesic requirement in laparoscopic sleeve gastrectomy. A prospective randomized double-blind trial. Seventy-three patients aged 18 to 65 years (ASA II-III) undergoing laparoscopic sleeve gastrectomy were included. The patients were divided into 3 groups. Intravenous (IV) ketamine (0.5 mg/kg/h), dexmedetomidine (0.5 mcg/kg/h), and lidocaine (2 mg/kg/h) were administered to Groups K, D and L, respectively. Postoperative infusions were continued for 12 hours. Visual Analog Scale (VAS) scores (during rest and movement) in the admission to postanesthesia care unit, 1, 3, 6, 12, 24, 48 hours, and on day 15 were assessed postoperatively. Rescue analgesia requirement, the number of patients with nausea, retching, and vomiting, time to mobilization, and hospital length of stay (LOS) were recorded. VASrest values during all measurements in the first 24 hours, and VASmovement values in the first 6 hours and at 24 hours were lower in Group L when compared to Group K and Group D (P < .001, P < .001, P = .008, respectively). VASrest at 48 hours and VASmovement at 12 and 48 hours were lower in Group L when compared to Group K (P = .044, P = .001 and P = .011, respectively). There was no statistically significant difference between Group D compared to the other two groups at these times (P > .05). The requirement of rescue analgesia on postoperative day 1 was significantly higher in Group K (P < .001). Hospital LOS was shorter in Group L than in the other groups (P = .002). IV lidocaine added to multimodal analgesia provided better pain control in the early postoperative period compared to dexmedetomidine and ketamine and decreased the hospital LOS.