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    Premptive analgesia with ketamine or tenoxicam before remifentanil anesthesia [Remifentanil anestezisinden önce ketamin ve tenoksikam ile preemptif analjezi]
    (2003) Öztin Ö?ün C.; Duman A.; Erol A.; Kirgiz E.N.; Ökesli S.; Duman I.
    The postoperative analgesic effectiveness and side effects of preemptive ketamine and tenoxicam, which were used before remifentanil-based anesthesia, were compared in gynecological laparotomies. Before anesthesia induction, 4 ml saline i.v. was administered to Group P (n=31), 1 mg/kg ketamine to Group K (n=30) and 40 mg tenoxicam to Group T (n=33). Anesthesia was induced with 1-1.5 mg/kg propofol and 0.6 mg/kg rocuronium and maintaned with 0.2 mg/kg/hour remifentanil and 67 % nitrous oxide and sevoflurane. Sedation, pain scores and meperidine consumptions (after extubation and at 3, 6, 12, 24, 48th hours) were recorded. Hemodynamic and respiratory variables were similar in all groups. Sedation level was higher in ketamine group than placebo (p<0.05). Pain scores were lower in Group K than placebo at first 6 hours and at 48th hour, but pain scores were lower in Group T than placebo at all times (p<0.05). Meperidine consumption was lower at 6, 12, 24th hour than the other groups in Group T, it was similar between tenoxicam and ketamine groups in 3rd, 48th hour and totally (p<0.05). It was thought that preincisional tenoxicam has preemptive effectiveness but ketamine does not, although it has a short analgesic effect and is likely to prevent hyperalgesia.