Sensory changes and pain after abdominal hysterectomy: a comparison of anesthetic supplementation with fentanyl versus magnesium or ketamine

Anesthesia and Analgesia
O H Wilder-SmithK R Rifat

Abstract

Drugs interacting with opioid or N-methyl-D-aspartate (NMDA) receptors may have differing effects on post-surgical sensory changes, such as central inhibition or spinal excitation. We compared the effect of supplementing isoflurane/N2O/O2 anesthesia with an opioid agonist (fentanyl [n = 15]) or two drugs inhibiting the NMDA system differently (magnesium, ketamine [n = 15 in each group]) on sensory changes after abdominal hysterectomy. Electric sensation, pain detection, and pain tolerance thresholds were determined (preoperatively and 1, 4, 24 h, and 5 days postoperatively) in arm, thoracic, incision, and leg dermatomes together with pain scores and cumulative morphine consumption. Thresholds relative to the arm were derived to unmask segmental sensory changes hidden by generalized changes. Absolute thresholds were increased 1-24 h, returning to baseline on Day 5, without overall differences among drugs. Fentanyl thresholds were lower 1 h and higher 5 days postoperatively compared with magnesium and ketamine; thresholds were lower at 24 h for magnesium versus ketamine. Relative thresholds increased compared with baseline only with fentanyl (1-4 h); none decreased. Pain scores and morphine consumption were similar. Thus, all adj...Continue Reading

References

Jan 1, 1992·Pain·D Le BarsT De Broucker
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Jun 1, 1996·British Journal of Anaesthesia·O H Wilder-SmithL Arendt-Nielsen
Oct 6, 1997·Acta Anaesthesiologica Scandinavica·C H Wilder-SmithO H Wilder-Smith

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Citations

Mar 13, 1999·Annual Review of Psychology·J C Craig, G B Rollman
Jun 23, 2012·Pharmacological Reviews·Anne Estrup OlesenAsbjørn Mohr Drewes
May 1, 2021·Nutrients·Véronique MorelGisèle Pickering

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