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Lipoabdominoplasty and liposuction are one of the most common plastic surgeries. The management of postoperative pain is complex. Non Steroidal Anti Inflammatory Drugs (NSAIDs) are insufficient, while opioids are avoided by their adverse effects and regional techniques are hampered by a premature discharge. In this context, the investigators seek an intraoperative multimodal analgesic technique blocking NMDA receptors with ketamine plus magnesium to significantly decrease postoperative pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group (C) | Sham Comparator | 50 mL syringe with saline, plus 1 flask of 100 mL saline (Saline) |
|
| Ketamine group (K) | Experimental | 50 mL syringe with ketamine (50mg / 50ml), plus 1 flask of 100 mL saline (Ketamine) |
|
| Magnesium + ketamine group (MGK) | Experimental | 50mL syringe with ketamine (50mg / 50ml), plus a flask of 100ml of saline with 5 g of magnesium sulfate (Ketamine + magnesium) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Saline | Drug | 50 mL syringe will be infused at 0.3 mL/Kg in bolus and then 0.15 mL/Kg/h 100 mL flask will be infused at 1mL/Kg in bolus for 30 min and then 0.25mL/Kg/h |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioids consumption | 12 h after surgery | |
| Postoperative Pain (Postoperative Pain and Disability Scale) | Postoperative Pain and Disability Scale (Body-PPDS) will be used to quantify pain | 2, 7, 14, 21, 45 and 90 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Early postoperative pain (Visual analogue pain scale) | Visual analogue pain scale (0-10) will be used to quantify pain | 0, 2, 4, 6, 12 and 24 h after surgery |
| Early postoperative pain (Time to first request for supplemental analgesia) |
| Measure | Description | Time Frame |
|---|---|---|
| Drug Side Effect | Hallucinations, unpleasent dreams or some patient discomfort, sedation level, pruritus, hypotension, bradycardia, urinary retention, nausea, vomiting. | First day after surgery |
| Other Variables |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Clinico de la Universidad de Chile | Santiago | RM | 7690306 | Chile |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| D007649 | Ketamine |
| D008274 | Magnesium |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
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| Ketamine | Drug | 50 mL syringe will be infused at 0.3 mL/Kg in bolus and then 0.15 mL/Kg/h 100 mL flask will be infused at 1mL/Kg in bolus for 30 min and then 0.25mL/Kg/h |
|
| Ketamine + magnesium | Drug | 50 mL syringe will be infused at 0.3 mL/Kg in bolus and then 0.15 mL/Kg/h 100 mL flask will be infused at 1mL/Kg in bolus for 30 min and then 0.25mL/Kg/h |
|
Time to first request for supplemental analgesia.
| 1 day |
| Disability (Time delay in returning to work) | Time delay in returning to work. | 90 days |
| Postoperative Chronic Pain (McGill scale) | McGill scale for chronic painwill be used to quantify pain | Day after surgery, 7, 30 and 90 days after surgery |
Sociodemographic variables; surgical variables as liters of aspirated fat, weight of resected flap, operative time, bleeding measured as the difference between pre and postoperative hemoblobinemia, immediate postoperative complications such as bleeding or hematoma and thromboembolic complications; anesthetic variables as total amount of remifentanil and sevorane consumption.
| First day |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |
| D017670 |
| Sodium Compounds |
| D003510 | Cyclohexanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D008673 | Metals, Alkaline Earth |
| D004602 | Elements |
| D019565 | Metals, Light |
| D008670 | Metals |