الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Aim of the work
to assess the efficacy of preoperative administration of ketamine versus magnesium sulfate as preemptive analgesia in gynecologic laparoscopic surgery by comparing haemodynamics, visual analogue scale, time to first analgesic requirement, total dose of analgesia and side effects.
Summary and Conclusion
This study was carried out in EL-Minia University Hospital sixty female patients scheduled for gynecologic laparoscopic under general anesthesia. Patients were randomly divided into three equal groups; group K (ketamine group, n=20), they received ketamine 1.5 mg/kg just before induction of anesthesia group M (magnesium sulphate group n=20) they received 4 gm of magnesium sulphate before induction of anesthesia & group C (control group, n=20), they received saline before induction of anesthesia.
The aim of this work is to assess the efficacy of preoperative administration of ketamine versus magnesium sulfate as preemptive analgesia in gynecologic laparoscopic surgery by comparing haemodynamics, visual analogue scale, time to first analgesic requirement, total dose of analgesia and side effects.
Preoperative assessment and preparation of the patients were done by careful history taking, general, examination and routine investigation. We assessed the haemodynamic changes, visual analogue scale (VAS), amount of analgesic requirement after operation, time to the first analgesic request , sedation score and side effects between three groups.
Statistical analysis was done by student’s t-test inside the group and ANOVA test between three groups.
Comparison between three groups as regards age, weight, ASA status and duration of surgery reveled that no significant differences was found.
Statistical analysis reveled that no significant differences was found between three groups as regards heart rate ,mean blood pressure and oxygen saturation pre operative, intra operative and postoperative.
Statistical analysis reveled that no significant differences was found between three groups as regards sedation score.
In our study the incidence of postoperative nausea and vomiting was (15%) in group K , nausea (25% ) and vomiting (20%) in group M and in group C the incidence of nausea was (15%) and vomiting (10%).
There was no significant difference between three groups as regards visual analogue scale since it was (5.5±2.2) in group K, (5.9±1.97) in group M and (5.65±2.36) ) in group C at 15 minute postoperative.
There was no significant difference between three groups as regards time to 1st analgesic request since it was (15.4±5.67) minute in group K, (14.2±6.01) minute in group M and (15.55±5.30) minute in group C at 15 minute postoperative.
There was no significant difference between three groups as regards mean of total dose of analgesia since it was (67.5±19.15) mg of ketorelac in group K, (63±19.1) mg of ketorelac in group M and (65±19.26) mg of ketorelac in group C.
We concluded that preoperative administration of ketamine (0.15 mg/Kg) or magnesium sulphate 4 gm as single dose failed to produce adequate postoperative analgesia in gynecologic laparoscopic surgery.
From the results of this study and previous studies we recommend further studies on the use of perioperative magnesium sulphate or ketamine hydrochloride as a continuous infusion rather than single dose.