Low-dose subcutaneous ketamine for postoperative pain management in Rwanda: a dose-finding study

Tuchscherer, Jon; McKay, William P.; Twagirumugabe, Théogène

doi:10.1007/s12630-017-0914-0

Cited by 13 publications

(12 citation statements)

References 25 publications

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“…The provision of adequate pain relief after surgery is an ethical responsibility of healthcare providers and a fundamental right of every patient [ 20 – 22 ]. Its importance has been emphasized during the early stages of recovery [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Undesirable Postoperative Anesthesia Outcomes at Two National Referral Hospitals: A Cross-Sectional Study in Eritrea

Andemeskel

Elsholz

Gebreyohannes

et al. 2020

Anesthesiology Research and Practice

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Background. Postoperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the postoperative period. Method. A cross-sectional study design was applied on 470 patients who underwent different types of surgeries within a three-month period. Patients were interviewed 24 hours after operation (POD 1) using the Leiden Perioperative care Patient Satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered, and the measurements of that dimension are presented in this report. Items of the dimension were standardized and measured using a five-point Likert scale from “Not at all” to “Extremely.” Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Results. The prevalence were computed in two manners, prevalence of those with ‘at least a little bit’ outcomes, which was computed to see the total occurrence of these outcomes, and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, postoperative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6%, respectively. The rest of the postoperative undesirable outcomes were less frequently reported. Conclusion. Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed.

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Section: Discussionmentioning

confidence: 99%

Undesirable Postoperative Anesthesia Outcomes at Two National Referral Hospitals: A Cross-Sectional Study in Eritrea

Andemeskel

Elsholz

Gebreyohannes

et al. 2020

Anesthesiology Research and Practice

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“…As shown in The provision of adequate pain relief after surgery is an ethical responsibility of healthcare providers and a fundamental right of every patient (25)(26)(27). Postoperative pain can have a significant effect on patient recovery by improving clinical outcomes, avoiding clinical complications, and finally saving health care resources (28).…”

Section: Association Of Outcomes With Types Of Surgery and Types Of Amentioning

confidence: 99%

Undesirable Perioperative Anesthesia Outcomes at Two National Referral Hospitals, a cross sectional study in Eritrea

Andemeskel

Elsholz

Gebreyohannes

et al. 2020

Preprint

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Background: Perioperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious intraoperative and postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the perioperative period. Method: A cross sectional study design was applied on 470 patient who underwent different types of surgeries with in a three month period. Patients were interviewed 24 hours after operation using the Leiden preoperative care patient satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered and the measurement of that dimension are presented in this report. Items of the dimension were standardized and measured using a five point Likert scale from “Not at all” to “Extremely”. Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Statistical significance level was set at p< 0.05. Results: The prevalence of undesirable anesthesia outcomes were computed in two manners; prevalence of those with ‘at least a little bit’ outcomes which was computed to see the total occurrence of these outcomes and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, post-operative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6% respectively. The rest post-operative undesirable outcomes were less frequently reported. Conclusion: Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of the proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed. Local guidelines should also be available in these settings for the treatment of acute postoperative pain or other outcomes. Keywords: Leiden preoperative care patient satisfaction questionnaire (LPPSq), Perioperative care, Surgery, Undesirable anesthesia outcomes.

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“…Buvanendran et al [ 10 ] indicated that oral ketamine provided improved postoperative analgesia after amputation surgery without increased risk of adverse effects. Tuchscherer et al [ 11 ] found that adding subcutaneous ketamine to standard analgesic regime resulted in a reduction of postoperative pain scores.…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous ketamine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy

Fan

Zhou

2017

Medicine

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Background:We conducted a meta-analysis to assess the efficacy and safety of ketamine for reducing pain and narcotic use for patients undergoing laparoscopic cholecystectomy (LC).Methods:PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) were regarded as eligible in our study. After testing the heterogeneity across RCTs, data were aggregated for fixed/random effect model according to the I2 statistic. The meta-analysis was conducted using Stata 11.0 software.Results:Five studies were included, with a total sample size of 212 patients. Current meta-analysis revealed that there were significant differences regarding postoperative pain score at 12 hours [standard mean difference (SMD) = −0.322, 95% confidence interval (95% CI): −0.594 to −0.050, P = .020], 24 hours (SMD = −0.332, 95% CI: −0.605 to −0.059, P = .017), and 48 hours (SMD = −0.340, 95% CI: −0.612 to −0.068, P = .014). Ketamine intervention was found to significantly decrease narcotic use at 12 hours (SMD = −0.296, 95% CI: −0.567 to −0.025, P = .033), 24 hours (SMD = −0.310, 95% CI: −0.581 to −0.039, P = .025), and 48 hours (SMD = −0.338, 95% CI: −0.609 to −0.066, P = .015).Conclusion:Ketamine appeared to significantly reduce postoperative pain and narcotic use following LC. On the basis of the current evidence available, higher quality RCTs are still required for further research.

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Low-dose subcutaneous ketamine for postoperative pain management in Rwanda: a dose-finding study

Cited by 13 publications

References 25 publications

Undesirable Postoperative Anesthesia Outcomes at Two National Referral Hospitals: A Cross-Sectional Study in Eritrea

Undesirable Postoperative Anesthesia Outcomes at Two National Referral Hospitals: A Cross-Sectional Study in Eritrea

Undesirable Perioperative Anesthesia Outcomes at Two National Referral Hospitals, a cross sectional study in Eritrea

Effect of intravenous ketamine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy

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