European journal of anaesthesiology
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Randomized Controlled Trial
Combination of low doses of intrathecal ketamine and midazolam with bupivacaine improves postoperative analgesia in orthopaedic surgery.
Intrathecal ketamine produces a short period of analgesia with stable haemodynamics. Midazolam with bupivacaine prolongs the duration of analgesia when administered intrathecally but does not prevent hypotension. The objective of this study was to assess the effect of a combination of intrathecal bupivacaine, ketamine and midazolam on the duration of analgesia and haemodynamic parameters. ⋯ A low dose of midazolam and ketamine with bupivacaine intrathecally results in prolonged analgesia and less haemodynamic fluctuations. However, the safety of this combination needs to be proved before its use in clinical practice.
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Randomized Controlled Trial
Topical ketamine and morphine for post-tonsillectomy pain.
Tonsillectomy is frequently associated with postoperative pain of considerable duration, which is usually accompanied by the substantial consumption of both opioid and non-opioid analgesics. Despite the use of different surgical and anaesthetic techniques in the search for safe and effective post-tonsillectomy pain relief, this problem remains a clinical dilemma. The aim of the current study was to evaluate the potential effects of topically administered ketamine and morphine by an oral rinse into the tonsillar fossae. ⋯ Topical ketamine and morphine seems to be a safe and easy analgesic approach for decreasing adenotonsillectomy pain.