@article {Canbay642, author = {Ozgur Canbay and Ozlem Karakas and Nalan Celebi and Lutfiye Peker and Fehmi Coskun and Ulku Aypar}, title = {The preemptive use of diclofenac sodium in combination with ketamine and remifentanil does not enhance postoperative analgesia after laparoscopic gynecological procedures}, volume = {27}, number = {5}, pages = {642--645}, year = {2006}, publisher = {Saudi Medical Journal}, abstract = {OBJECTIVE: To evaluate the preemptive effects of diclofenac sodium, in combination with remifentanil and ketamine.METHODS: A prospective, randomized, double blind, placebo-controlled trial was carried out at the Hacettepe University Hospital, Ankara, Turkey from September to December 2004. Forty-three, American Society of Anesthesiology physical status group I-II women, aged \>18~years, who would undergo both diagnostic and operative laparoscopic surgery were randomly assigned into 2 groups. All patients received intraoperative 0.1 ugr.kg-1min-1 remifentanil infusion. Diclofenac (1~mg.kg-1 intramuscular) was administered, 20 minutes before the operation. Ketamine (0.8~mg.kg-1 intravenously) was administered 5 minutes before the skin incision and at completion of skin closure. We divided the patients into 2 groups; Group I (diclofenac + remifentanil + ketamine), Group II (remifentanil + ketamine). Pain was evaluated postoperatively using the visual analogue scale (VAS) while global satisfaction by verbal rating scale (VRS).RESULTS: All 43 female patients have a mean {\textpm} SD age of 32.3 {\textpm} 6.5~years, height of 163 {\textpm} 5.3~cm, and weight of 62.9 {\textpm} 9.5~kg. The VAS and VRS scores and also time to first analgesic request were not different between the groups. In all groups, \>98\% of the patients were satisfied or very satisfied.CONCLUSION: We have not found any preemptive or additive effect of diclofenac sodium with the concomitant use of ketamine.}, issn = {0379-5284}, URL = {https://smj.org.sa/content/27/5/642}, eprint = {https://smj.org.sa/content/27/5/642.full.pdf}, journal = {Saudi Medical Journal} }