title: Oral ketamine and dexmedetomidine in adults' burns wound dressing--A randomized double blind cross over study.
abstract: Study was designed to compare analgesic efficacy and side effects of oral dexmedetomidine and ketamine in adults for burn wound dressing. Sixty healthy adults with thermal burns with burn area (20-50%) were randomly assigned into 2 groups. In Group K 5mg/kg ketamine and in Group D 4 mcg/kg dexmedetomidine was given orally. Patients crossed over to the other group the following day. Visual analogue score, sedation score, haemodynamic parameters were recorded from 30min after drug administration to 2h after procedure. Patients' preference was also recorded. Mean VAS score was significantly reduced from baseline in both the groups at all time points (P<0.05). Pain relief in Group K (overall mean VAS 2.6±0.6cm) was significantly better when compared to Group D (overall mean VAS 3.8±0.8cm). Patients in group K were significantly more sedated (median 3) when compared to group D (median 2), P<0.05. Delirium and excessive salivation were significant complications observed with ketamine. More patients preferred ketamine (63.3%) than dexmedetomidine (36.7%), P<0.05. Oral ketamine and dexmedetomidine produced significant pain relief during burns wound dressing. Oral ketamine produced significantly better pain relief than dexmedetomidine but was associated with delirium and excessive salivation.
authors.affiliation: Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Institute of National Importance, Pondicherry 605 006, India. p_kundra@hotmail.com
authors.forename: Pankaj
authors.initials: P
authors.lastname: Kundra
authors.forename: Savitri
authors.initials: S
authors.lastname: Velayudhan
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Krishnamachari
authors.forename: Suman Lata
authors.initials: SL
authors.lastname: Gupta
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D001458:Bandages; D002056:Burns / Q000150:complications / Q000628:therapy*; D018592:Cross-Over Studies; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D007649:Ketamine
keywords: Burns; Dexmedetomidine; Ketamine; Pain relief