Objective: To compare the effect of ketamine, lidocaine, acetaminophen, and dexmedetomidine combined with morphine patient-controlled analgesia for opium addicts after tibial fracture surgery. Methods: This double-blind clinical trial included opium-addicted patients undergoing tibia fracture surgery. Patients were recruited and randomized to four different groups including the ketamine group, the lidocaine group, the acetaminophen group, and the dexmedetomidine group. The hemodynamic parameters such as heart rate (HR), mean arterial pressure, and arterial SaO2, alongside visual analog scale pain scores, sedation assessed by Ramsay score, nausea and vomiting, and opioid use were recorded and compared among the four groups. Results: This study included 140 patients, aged 37 (32, 41) years, with 92 males and 48 females, and each group had 35 patients. Dexmedetomidine-sedated subjects had the lowest blood pressure from 1 to 24 h after surgery, decreased HR at 12 and 24 h after surgery, and more satisfactory sedation (P<0.05). Notwithstanding no significant difference was noted in the pain scores, or nausea and vomiting among the groups (P>0.05). Conclusions: Dexmedetomidine has a better sedation effect compared to ketamine, lidocaine, and acetaminophen for pain control, but the final choice hinges on the patients' physical condition and the anesthesiologist's preference. Clinical registration: It is registered in Iranian Registry Clinical Trial by code IRCT20141209020258N146.

Hesameddin Modir;Esmail Moshiri;Mehran Azami;Maryam Joshaghani Zad;Amir Almasi Hashiani

Anesthesiology Department Arak University of Medical Sciences Arak,Iran;Department of Orthopedic Surgery,Arak University of Medical Sciences,Arak,Iran;Student Research Committee,Arak University of Medical Sciences Arak,Iran;Department of Epidemiology,School of Health,Arak University of Medical Sciences,Arak,Iran

急性病杂志（英文版）

[1]Hesameddin Modir;Esmail Moshiri;Mehran Azami;Maryam Joshaghani Zad;Amir Almasi Hashiani-.Comparative efficacy of ketamine, lidocaine, acetaminophen, and dexmedetomidine combined with morphine patient-controlled analgesia in treating opium-addicted patients undergoing tibia fracture surgery: A randomized clinical trial)[J].急性病杂志（英文版）,2022(05):181-187

opium,addicted,sedated,IRCT20141209020258N146

Comparative,efficacy,ketamine,lidocaine,acetaminophen,dexmedetomidine,combined,morphine,controlled,analgesia,treating,patients,undergoing,fracture,surgery,randomized,clinical,trial,Objective,To,effect,addicts,after,tibial,Methods,This,double,blind,included,Patients,were,recruited,four,different,groups,including,hemodynamic,parameters,such,heart,rate,mean,arterial,pressure,SaO2,alongside,visual,analog,scale,pain,scores,sedation,assessed,by,Ramsay,nausea,vomiting,opioid,recorded,compared,among,Results,study,aged,years,females,each,had,Dexmedetomidine,subjects,lowest,blood,from,decreased,more,satisfactory,Notwithstanding,significant,difference,was,noted,Conclusions,has,better,but,final,choice,hinges,physical,condition,anesthesiologist,preference,Clinical,registration,It,registered,Iranian,Registry,Trial,code

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