ĐÁNH GIÁ HIỆU QUẢ CỦA KETAMINE LIỀU DUY NHẤT TRONG GIẢM ĐAU ĐA MÔ THỨC SAU MỔ Ở BỆNH NHÂN NÂNG NGỰC BẰNG TÚI ĐỘN

Abstract

Objectives: To evaluate the efficacy and safety of a single-dose intravenous ketamine in post-operative multimodal analgesia following breast augmentation surgery. Methods: A prospective, randomized, controlled study was conducted on 128 patients with ASA I - II (according to the American Society of Anesthesiologists: ASA classification) undergoing breast augmentation with implants placed beneath the pectoralis major muscle at Le Huu Trac National Burn Hospital from January to November 2025. Group 1 (n = 64) received a single intravenous dose of ketamine (0.6 mg/kg) administered at the end of surgery, followed by post-operative analgesia using intravenous patient-controlled analgesia (IV-PCA) fentanyl. Group 2 (n = 64) received IV-PCA fentanyl alone. Pain scores (VAS at rest and during movement), total fentanyl consumption, number of PCA boluses, rescue analgesia, and adverse effects within the first 24 hours following surgery were evaluated Results: Total fentanyl consumption was statistically significant lower in group 1 compared to group 2 (405.9 ± 57.0µg vs. 662.5 ± 82.2µg; p < 0.05); the number of additional analgesic bolus demands was also lower in group 1 while VAS pain scores were comparable between the two groups. The incidence of nausea and dizziness did not differ significantly, and no patients in either group experienced hallucinations. Conclusion: A single-dose intravenous ketamine significantly reduces postoperative opioid requirements following breast augmentation surgery without increasing adverse effects. ketamine is an effective component of a multimodal analgesic regimen to limit opioid-related side effects.