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  • Title: The preemptive use of diclofenac sodium in combination with ketamine and remifentanil does not enhance postoperative analgesia after laparoscopic gynecological procedures.
    Author: Canbay O, Karakas O, Celebi N, Peker L, Coskun F, Aypar U.
    Journal: Saudi Med J; 2006 May; 27(5):642-5. PubMed ID: 16680253.
    Abstract:
    OBJECTIVE: To evaluate the preemptive effects of diclofenac sodium, in combination with remifentanil and ketamine. METHODS: A prospective, randomized, double blind, placebo-controlled trial was carried out at the Hacettepe University Hospital, Ankara, Turkey from September to December 2004. Forty-three, American Society of Anesthesiology physical status group I-II women, aged >18 years, who would undergo both diagnostic and operative laparoscopic surgery were randomly assigned into 2 groups. All patients received intraoperative 0.1 microg x kg(-1)min(-1) remifentanil infusion. Diclofenac (1 mg x kg(-1) intramuscular) was administered, 20 minutes before the operation. Ketamine (0.8 mg x kg(-)1 intravenously) was administered 5 minutes before the skin incision and at completion of skin closure. We divided the patients into 2 groups; Group I (diclofenac + remifentanil + ketamine), Group II (remifentanil + ketamine). Pain was evaluated postoperatively using the visual analogue scale (VAS) while global satisfaction by verbal rating scale (VRS). RESULTS: All 43 female patients have a mean +/- SD age of 32.3 +/- 6.5 years, height of 163 +/- 5.3 cm, and weight of 62.9 +/- 9.5 kg. The VAS and VRS scores and also time to first analgesic request were not different between the groups. In all groups, >98% of the patients were satisfied or very satisfied. CONCLUSION: We have not found any preemptive or additive effect of diclofenac sodium with the concomitant use of ketamine.
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