[Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome]

doi:10.3760/cma.j.issn.0376-2491.2017.46.008

科研成果详情

题名	[Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome]
其他题名	Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome
作者	Lou, Qunbing 2; Nan, Ke1; Xiang, Fangfang 1; Chen, Xiaozhen 1; Zhu, Weisheng 1; Zhang, Xutong1; Li, Jun1
发表日期	2017-12-12
发表期刊	Zhonghua yi xue za zhi 影响因子和分区
语种	英语
原始文献类型	期刊论文
关键词	Breast neoplasms Dose-response relationship, drug Ketamine Pain, postoperative Surgical procedures, operative.
其他关键词	Pain ; postoperative ; Ketamine ; Dose-response relationship ; drug ; Breast neoplasms ; Surgical procedures ; operative
摘要	Objective: To investigate the effects of multi-day low dose ketamine infusion for postmastectomy pain syndrome (PMPS) after breast cancer surgery. Methods: This study was a prospective randomized controlled trial. From June 2015 to May 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University, 66 patients with breast cancer surgery were randomly divided into control group (group C) and ketamine group (group K). Patients in group K were infused with 0.5 mg/kg of ketamine mixed in 250 ml of 0.9% normal saline in 1 h daily for 7 days. Patients in group C were infused the same dose of 0.9% normal saline. Anesthesia induction in both groups were given intravenous midazolam, sufentanil, propofol, vecuronium and intermittent positive pressure ventilation after tracheal intubation, anesthesia was maintained with propofol and remifentanil. After awakening, all patients were monitored in postanesthesia care unit (PACU) and given patient-controlled intravenous analgesia(PCIA). Pain scores were assessed using visual analogue scales (VAS) during PACU, 4 h, 24 h and 2-5 d after surgery, simultaneously analgesic requirement were recorded. Patients were evaluated Hospital Anxiety and Depression Scale (HADS) 5 d after surgery . The patients were followed up for 6 months. At 3 m, 6 m after surgery, the incidence of PMPS, the level of pain, pain site and HADS scale were assessed. Results: The VAS score uring PACU, 4 h, 24 h and 2-5 d after surgery in group K( (2.5±0.8), (2.4±0.5), (2.4±0.5), (2.0±0.4), (1.5±0.5), (1.0±0.4), 1(1), respectively) was lower than those in group C ((2.9±1.0), (2.9±0.6), (2.6±0.5), (2.3±0.5), (1.8±0.6), (1.5±0.5), 1(0), respectively). There was statistically difference between the two groups (all P<0.05). The consumption of analgesics required at each time postoperation in group K were also lower than that of group C(all P<0.05). Followed up for 6 months, 2 lost in group C, 1 lost in group K. The incidence of PMPS in group K at 3 months and 6 months after surgery was significantly lower(25% and 22%) than that in group C(52% and 45%)(χ(2)=4.729, 3.842, all P<0.05). There were no significant difference in pain level and site between two groups of PMPS patients (all P>0.05). There were no significant difference of HADS scale preoperative and 5 d after surgery between two groups (all P>0.05); and HADS scale in group K at 3 m and 6 m after surgery was significantly lower than that in group C(all P<0.05). Conclusion: Perioperative continuous multi-day low dose ketamine infusion can effectively reduce the incidence of PMPS after breast cancer surgery.
其他摘要	Objective To investigate the effects of multi-day low dose ketamine infusion for postmastectomy pain syndrome (PMPS) after breast cancer surgery. Methods This study was a prospective randomized controlled trial. From June 2015 to May 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University,66 patients with breast cancer surgery were randomly divided into control group ( group C ) and ketamine group ( group K). Patients in group K were infused with 0.5 mg/kg of ketamine mixed in 250 ml of 0.9% normal saline in 1 h daily for 7 days. Patients in group C were infused the same dose of 0.9% normal saline. Anesthesia induction in both groups were given intravenous midazolam, sufentanil, propofol, vecuronium and intermittent positive pressure ventilation after tracheal intubation, anesthesia was maintained with propofol and remifentanil. After awakening, all patients were monitored in postanesthesia care unit (PACU) and given patient-controlled intravenous analgesia ( PCIA). Pain scores were assessed using visual analogue scales ( VAS) during PACU, 4 h,24 h and 2 - 5 d after surgery, simultaneously analgesic requirement were recorded. Patients were evaluated Hospital Anxiety and Depression Scale ( HADS) 5 d after surgery. The patients were followed up for 6 months. At 3 m, 6 m after surgery, the incidence of PMPS,the level of pain,pain site and HADS scale were assessed. Results The VAS score uring PACU, 4 h,24 h and 2-5 d after surgery in group K( (2.5 ± 0.8), (2.4 ± 0.5),(2.4 ± 0.5),(2.0 ± 0.4),(1.5 ±0.5 ),( 1.0 ± 0.4),1(1),respectively) was lower than those in group C ( (2.9 ± 1.0),(2.9 ± 0.6),(2.6±0.5),(2.3 ±0.5),(1.8 ±0.6),(1.5 ± 0.5),1 (0), respectively). There was statistically difference between the two groups ( all P < 0.05 ). The consumption of analgesics required at each time postoperation in group K were also lower than that of group C ( all P < 0.05 ). Followed up for 6 months, 2 lost in group C, 1 lost in group K. The incidence of PMPS in group K at 3 months and 6 months after surgery was significantly lower(25% and 22% ) than that in group C(52% and 45% ) (χ~2 =4.729,3.842,all P < 0.05 ). There were no significant difference in pain level and site between two groups of PMPS patients ( all P >0.05 ). There were no significant difference of HADS scale preoperative and 5 d after surgery between two groups ( all P >0.05 ); and HADS scale in group K at 3 m and 6 m after surgery was significantly lower than that in group C( all P < 0.05). Conclusion Perioperative continuous multi-day low dose ketamine infusion can effectively reduce the incidence of PMPS after breast cancer surgery.
出版者	Chinese Medical Association
ISSN	0376-2491
卷号	97 期号:46 页码:3636-3641.
DOI	10.3760/cma.j.issn.0376-2491.2017.46.008
页数	6
收录类别	PUBMED ; CSCD ; 万方 ; SCOPUS ; PKU ; 北大核心 ; ISTIC
学科领域	医药、卫生
URL	查看原文
CSCD记录号	CSCD:6132874
PubMed ID	29275607
SCOPUSEID	2-s2.0-85049244159
通讯作者地址	[Li, Jun]Department of Anesthesiology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,325027,China
Scopus学科分类	Medicine (all)
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/34533
专题	第二临床医学院、附属第二医院、育英儿童医院其他_附属义乌医院（义乌市中心医院）
通讯作者	Li, Jun
作者单位	1.Department of Anesthesiology,The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou,325027,China; 2.Department of Anesthesiology,Affiliated Yiwu Hospital of Wenzhou Medical University,Yiwu,322000,China
第一作者单位	附属义乌医院（义乌市中心医院）
通讯作者单位	第二临床医学院，附属第二医院、育英儿童医院; 附属第二医院
第一作者的第一单位	附属义乌医院（义乌市中心医院）
推荐引用方式 GB/T 7714	Lou, Qunbing,Nan, Ke,Xiang, Fangfang,et al. [Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome][J]. Zhonghua yi xue za zhi,2017,97(46):3636-3641..
APA	Lou, Qunbing., Nan, Ke., Xiang, Fangfang., Chen, Xiaozhen., Zhu, Weisheng., ... & Li, Jun. (2017). [Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome]. Zhonghua yi xue za zhi, 97(46), 3636-3641..
MLA	Lou, Qunbing,et al."[Effect of perioperative multi-day low dose ketamine infusion on prevention of postmastectomy pain syndrome]".Zhonghua yi xue za zhi 97.46(2017):3636-3641..