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the aim is to compare the effects of two different doses of intraarticular ketamine on postoperative pain scores and analgesic requirements.in knee artroscopy
All pateints are going to be operated under general anesthesia. At the end of the study patients are going to be randomyl seperated into 3 groups. The surgeon is going the following drugs intraarticulary.
Group KL1: 0.5 mg/kg ketamin in % 0..9 NaCl at a total volume of 20 ml Group KL2: 1 mg/kg ketamin in % 0.9 NaCl at a total volume of 20 ml Group SL: 20 ml % 0.9 NaCl ll patients are going to receive a periarticula injection of 10 ml 0.5 bupivacaine and patient controlled analgesia with morphine.
VAS scores and total analgesic requirement is going to be evaluated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ketamine 0.5 mg/kg | Active Comparator | ketamin 0.5 mg/kg intraarticular |
|
| Ketamine 1 mg/kg | Active Comparator | ketamin 1 mg/kg intraarticular injection |
|
| % 0.9 Saline | Sham Comparator | % 0.9 NaCL intraarticular injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ketamine 0.5 | Drug | İntrarticular Ketamine 0.5 mg/kg + 0.9 Nacl Total Volume 20 ml |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in postoperative pain scores throughout time evaluated by VAS | Pain scores are going to be evaluated by VAS scores at rest and VAS scores at activity | VAS scores at rest and during activity will be evaluated for 24 hours. The first measurement will be recorded immediately after surgery and at 30 minutes interval for the first hour. Afterwards at 2.4.6.12.24.hours postoperatively. |
| Difference in opioid Sparing effect measured through morphine amount delivered by a patient controlled analgesia device. | The total amount of morphine delivered by the patient controlled analgesia device in the first 24 hours will be recorded. | Total amount off delivered morphine will be recorded for 24 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Time for discharge measured by eligible for discharge criteria | The time needed to fullfill the dicharge criteria (stable vital signs, able to walk, able to eat, nausea and vomit free, able to mixture) | Discharge criterias will be evaluated every three hours until postoperative 24. hour. In patients who did not complete the discharge criteria in the postoperative 24 hours period, they will be defined as prolonged discharge. |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
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| Ketamine 1 | Drug | İntrarticular Ketamine 1 mg/kg + 0.9 NaCl Total Volume 20 ml |
|
|
| % 0.9 NaCl | Drug | Intraarticular %0.9 NaCl |
|
|
| D017670 |
| Sodium Compounds |