Volume 83, Issue 7 (October 2025)
Tehran Univ Med J 2025, 83(7): 498-507 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Majedi H, Espahbodi E, Hosseini Nejad S F, Vaziri M, Javaherforoushzadeh F, Rashidi M et al . Comparative study effect of Dexmedetomidine and Ketamine on post operative analgesia after laparoscopic cholecystectomy. Tehran Univ Med J 2025; 83 (7) :498-507
URL: http://tumj.tums.ac.ir/article-1-13741-en.html
URL: http://tumj.tums.ac.ir/article-1-13741-en.html
Hossein Majedi1 
, Ebrahim Espahbodi1 , Seyedeh Fatemeh Hosseini Nejad *2 , Mahshid Vaziri3 , Fatemeh Javaherforoushzadeh3 , Mahbubeh Rashidi3 , Rouzbeh Amiri Motlagh3
, Ebrahim Espahbodi1 , Seyedeh Fatemeh Hosseini Nejad *2 , Mahshid Vaziri3 , Fatemeh Javaherforoushzadeh3 , Mahbubeh Rashidi3 , Rouzbeh Amiri Motlagh3
1- Department of Anesthesiology and Intensive Care and Pain, Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex , Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Anesthesiology and Intensive Care and Pain, Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex , Tehran University of Medical Sciences, Tehran, Iran.| Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.| Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ,drhosseininejad@yahoo.com
3- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2- Department of Anesthesiology and Intensive Care and Pain, Pain Research Center, Neuroscience Institute, Imam Khomeini Hospital Complex , Tehran University of Medical Sciences, Tehran, Iran.| Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.| Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ,
3- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Abstract: (24 Views)
Background: Postoperative pain remains a major concern following abdominal surgeries, including laparoscopic cholecystectomy. Inadequate pain control may lead to increased opioid consumption, delayed recovery, prolonged hospitalization, and reduced patient satisfaction. Therefore, the use of anesthetic adjuvants with effective analgesic properties and minimal side effects has gained increasing attention. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, and dexmedetomidine, a highly selective α2-adrenergic agonist, are commonly used agents with distinct mechanisms of action. The present study aimed to compare the effects of intraoperative ketamine and dexmedetomidine on postoperative pain following laparoscopic cholecystectomy.
Methods: This randomized, double-blind, controlled clinical trial was conducted on 252 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned into three equal groups: ketamine, dexmedetomidine, and control. The ketamine group received an intravenous infusion of ketamine at a dose of 0.5 mg/kg/h, the dexmedetomidine group received 0.6 µg/kg/min of dexmedetomidine, and the control group received normal saline. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 1, 6, 12, and 24 hours postoperatively. Hemodynamic parameters, including heart rate and mean arterial pressure, were continuously monitored throughout the perioperative period. Data were analyzed using appropriate statistical tests, including ANOVA and nonparametric analyses.
Results: The results demonstrated that postoperative pain scores were significantly lower in the ketamine group compared to both the dexmedetomidine and control groups at all evaluated time points within the first 24 hours after surgery (P < 0.001). Although dexmedetomidine also provided effective analgesia compared with the control group, ketamine showed superior pain reduction. No statistically significant differences were observed among the three groups regarding hemodynamic parameters, indicating comparable cardiovascular stability.
.Conclusion: Intraoperative administration of ketamine was more effective than dexmedetomidine in reducing postoperative pain following laparoscopic cholecystectomy, without compromising hemodynamic stability. Nevertheless, both agents proved to be safe and effective options for postoperative pain management. Ketamine may be considered a preferable.
Methods: This randomized, double-blind, controlled clinical trial was conducted on 252 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned into three equal groups: ketamine, dexmedetomidine, and control. The ketamine group received an intravenous infusion of ketamine at a dose of 0.5 mg/kg/h, the dexmedetomidine group received 0.6 µg/kg/min of dexmedetomidine, and the control group received normal saline. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 1, 6, 12, and 24 hours postoperatively. Hemodynamic parameters, including heart rate and mean arterial pressure, were continuously monitored throughout the perioperative period. Data were analyzed using appropriate statistical tests, including ANOVA and nonparametric analyses.
Results: The results demonstrated that postoperative pain scores were significantly lower in the ketamine group compared to both the dexmedetomidine and control groups at all evaluated time points within the first 24 hours after surgery (P < 0.001). Although dexmedetomidine also provided effective analgesia compared with the control group, ketamine showed superior pain reduction. No statistically significant differences were observed among the three groups regarding hemodynamic parameters, indicating comparable cardiovascular stability.
.Conclusion: Intraoperative administration of ketamine was more effective than dexmedetomidine in reducing postoperative pain following laparoscopic cholecystectomy, without compromising hemodynamic stability. Nevertheless, both agents proved to be safe and effective options for postoperative pain management. Ketamine may be considered a preferable.
Keywords: dexmedetomidine, ketamine, laparoscopic cholecystectomy, postoperative pain, visual analogue scale.
Type of Study: Original Article |
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
