Comparison of preventive effects of flurbiprofen and low-dose ketamine on remifentanil-tnduced postoperative hyperalgesia

Objective To compare the preventive effects of flurbiprofen and low-dose ketamine on remifentanil-imluced postoperative hyperaigesia.Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes aged 18-59 yr undergoing elective laparoscopic cholecystectomy .(LC) were randomly divided into 4 groups ( n = 20 each) : small-dose remifentanil group (LR), large-dose remifentanil group (HR), large-dose remifentanil + ketamine group (HRK) and large-dose remffentanil + flurbiprofen group (HRF). In group LR, remifentanil 0.05 μg·kg-1·min-1 was infused intravenously. In group HR, HRK and HRF, remifentanil 0.4 μg·kg-1·min-1 was infused intravenously. In all groups, anesthesia was maintained with remifentanil in combination with sevoflurane. When the bile duct separation was started, ketamine 0.8 mg/kg and flurbiprefen 1.5 mg/kg were injected intravenously in group HRK and HRF respectively. VAS scores were recorded within 2 h and at4, 8, 12, 24 and 48 h after operation. The amount of pethidine consumed and postoperative nausea and vomiting were also recorded within 2 and 48 h after operation. Results The amount of pethidine consumed was smaller within 2 and 48 h afar operation and VAS scores were significantly lower within 2 h after operation in group LR, HRK and HRF than in group HR (P < 0.05 or 0.01 ). There were no significant differences in the amount of pethidine consumed within 2and48 h after operation between group HRK and-HRF and group LR (P 0.05), but VAS scores were significantly lower within 2 h after operation in group HRK and HRF than in group LR ( P < 0.05). There were no significant differences in the indexes mentioned above between group HRK and HRF ( P 0.05). Conclusion Both flnrbiprofen and low-dese ketamine have significant preventive effects on postoperative hyperalgesia induced by remifentanil with no difference between them. Key words: Ketamine; Flurbiprofen; Piperidines; Hyperalgesia