Giảm đau sau phẫu thuật cắt hoại tử bỏng và ghép da bằng hỗn hợp Ketamin - Fentanyl bệnh nhân tự điều khiển đường tĩnh mạch

Abstract

Objective: To evaluate the analgesic effects and adverse events of intravenous patient-controlled Ketamin - Fentanyl combination following excisional burn debridement and skin grafting surgery.
Subjects and methods: A prospective, descriptive study was conducted on 35 patients indicated for excisional burn debridement and skin grafting at the Adult Burn Department, Le Huu Trac National Burn Hospital, from October 2023 to October 2024. Patients received postoperative intravenous patient-controlled analgesia (PCA) with a Ketamin - Fentanyl combination.
Data were collected at specific time points as recorded in the research medical charts. Statistical analysis was performed using SPSS 22.0 software, presented as mean ± standard deviation ( ̅± SD), percentages (%), and comparisons between means using Student’s T - test, X2 test, with p < 0.05 considered statistically significant.
Results: The mean Visual Analog Scale (VAS) score at rest (VASr) was consistently < 3, and the mean VAS score during movement (VASm) was consistently < 4 throughout the study. At 48 hours after analgesic infusion, the mean VASr and VASm scores were significantly lower compared to baseline values, with p < 0.05 indicating statistical significance. The mean fentanyl consumption for pain relief over 24 hours was 398.59 ± 45.00 mcg, which was lower than that reported in studies using fentanyl alone. The A/D ratio was 100%, with no patients requiring rescue dose of analgesic. Ramsay sedation scores ranged from 2 to 4 during the study. Patient satisfaction rates were 51.42% very satisfied and 48.57% satisfied. Adverse events included nausea and vomiting in 2.86%, dizziness in 5.71%, and headache in 2.86% of patients.