Application of small dose Ketamine combined with Fentanyl for analgesia in elderly patients with femoral head arthroplasty

Objective To study the effect and complications of a small dose Ketamine combined with fentanyl for postoperative patient-controlled intravenous analgesia(PICA).Methods Sixty patients with femoral head arthroplasty undergoing intravenous postoperative analgesia were randomly divided into two groups:Fentanyl group(PICA-F,n=30) and Ketamine and Fentanyl group(PICA-KF,n=30).Dosages of both groups were as follows:1mg Fentanyl and 5 mg droperidol in PCIA-F group and 0.5 mg Fentanyl,5 mg Droperidol and 100 mg Ketamine in PCIA-KF group.Drugs in each group were diluted in normal saline 100 ml respectively and transfused by a disposable perfusion pump.The infusion dose was 2 ml/h and the instruction dose was 0.5 ml/every time for 15 mins.VAS,sedative score,nausea score,vomiting score,HR,RR,SPO2 and Fentanyl consumption were recorded at the points of 12 h,24 h in postoperative analgesia.Results There were no differences in HR,RR and SPO2 between two groups.VAS in group PICA-F was significantly higher than that in group PCIA-KF at the point of 24 h of PICA(P0.05).The sedative score in Group PICA-F was higher than that in group PCIA-KF at the point of 12 h of PICA(P0.05).The incidences of nausea and vomiting in group PICA-KF were significantly lower than that in group PICA-F(P0.05).Conclusion A small dose of Ketamine used for femoral head arthroplasty analgesia in elderly patients can reduce Fentanyl requirement,provide better postoperative analgesia and also reduce the incidences of nausea and vomiting.