Sample Nursing Article Review Paper
Dahi-Taleghani, Mastane, Benjamin Fazli, Mahshid Ghasemi, Maryam Vosoughian and Ali Dabbagh. “Effect of intravenous patient controlled ketamine analgesia on postoperative pain in opium abusers.” Anesthesiology and Pain Medicine 4.1 (2014): 1-5.
Brief Summary
Acute postoperative pain is amid the most horrible experiences that patients suffer and most analgesics have been employed for its suppression, particularly when it comes to chronic opium abusers (Dahi-Taleghani et al. 1). Ketamine acts as an antagonist anodyne that has both analgesic and anesthetic characteristics, which are not influenced to a similar degree in chronic opium abusers. The objective of this study was to examine the analgesic impact of ketamine when administered together with morphine in a patient-managed analgesic approach of severe pain control when judged against a placebo with respect to chronic opium abusers. Though there are a number of contentious issues concerning ketamine, recent medical studies have illustrated its efficacy as analgesia for chronic opium abusers. Nevertheless, the analgesic impacts of ketamine in facilitating medical results in chronic opium abusers, particularly when employed in pain management amid patients, are not clearly delineated and require further study.
In this study, every male patient from 18 to 65 years of age experiencing orthopedic surgical procedure in a university health facility was deemed part of the target population. Following the deliberation of exclusion and inclusion criteria and calculation of the size of the sample, the participants who were to take part in the study were chosen. Subsequent to the approval for ethical consideration, a double-blinded study was carried out. The overall sample for the study consisted of 140 male patients from the age of 18 to 65 years who were undertaking orthopedic surgical procedure; they were selected as participants in the study following their satisfaction of the inclusion criteria (Dahi-Taleghani et al. 2).
All the participants obtained a similar anesthetic approach; where ketamine (1 mg per mL) together with morphine (0.5 mg per mL) were administered to the first group (70 participants) as analgesia for pain control whereas the second group (70 participants) obtained morphine (0.5 mg per mL) in conjunction with normal saline. A p-value of below 0.05 was deemed statistically significant. The findings of the study were that in the first group (where ketamine and morphine were administered), the participants experienced lower postoperative pain than in the second group and needed minimal postoperative rescue analgesic treatment (Dahi-Taleghani et al. 3). Nonetheless, the unnecessary postoperative side effects were almost similar, though high extents of postoperative queasiness and vomiting were evident in the first group. The researchers concluded that the study expressed enhanced analgesic impacts following the application of intravenous analgesia for patient management on postoperative pain.
Measures Taken
The measures taken to protect humans engaged in the research were the control of postoperative pain with the help of a visual analog scale (VAS) and respiratory status with the application of respiratory levels and pulse oximetry. To enhance protection of the participants, extra intravenous morphine was administered to every patient having a pain score of over 3 in the course of the postoperative stage, irrespective of his study group; moreover, additional nasal oxygen was supplied if SpO2 dropped below 92%. Before carrying out the double-blinded study, the researchers first sought approval of the proposal of the research work for ethical concerns by the institutional review board (IRB) of Shahid Beheshti University of Medical Sciences in Iran (Dahi-Taleghani et al. 1-5). Moreover, the study received the endorsement of the Ethics Committee, the learning institution, and the Research Deputy who affirmed that the research practice adheres to the required ethical policies and informed consent was obtained prior to the commencement of the task. To ensure informed consent, every patient was visited on the eve of surgical operation, and the details of the study clearly explained. The patients were informed that taking part in the study was a totally voluntary concern and that they had the right to leave the study process at any stage if they deemed fit. Furthermore, it was articulated to the patients that rejection or approval of taking part in the study, or leaving the study at any point, had no impact on the treatment approach (encompassing the control of postoperative pain).
Data
After explanation of the progression of the study, informed consent for participation in the study was sought from the patients. The patients were first split into two groups where ketamine and morphine were administered in the first one and morphine and normal saline given in the second (Dahi-Taleghani et al. 1-5). In the course of the postoperative stage, the patients’ pain scores were managed with the application of VAS and recorded at one, six, and 24 hours following the surgical procedure. One potential error in the data collection of data that might have influenced the outcome is the total exclusion of females from the study. Such misrepresentation (application of just males) disregarded the negative effects of ketamine usually observed in female patients thus affecting the reliability of the study. Overall, the research expressed the efficacy of the analgesic influence of ketamine when used together with morphine, and as a patient controlled analgesia in chronic opium abusers going through orthopedic surgical treatment. To ensure that the study is more reliable and valid, there is a need to ensure equal representation of both male and female participants.
Work Cited
Dahi-Taleghani, Mastane, Benjamin Fazli, Mahshid Ghasemi, Maryam Vosoughian and Ali Dabbagh. “Effect of intravenous patient controlled ketamine analgesia on postoperative pain in opium abusers.” Anesthesiology and Pain Medicine 4.1 (2014): 1-5.