[Pre-incisional administration of ketamine reduced the postoperative pain].
This study was designed to examine the postoperative analgesic effect of pre-/post-incisional administration of ketamine. Thirty-nine female patients scheduled for transabdominal hysterectomy were randomly allocated into 3 groups. Patients in group-K1 (n = 13) received intravenous ketamine 100 mg before surgical incision and patients in group-K2 (n = 13) received the same after laparotomy. Group-C (n = 13) did not receive any ketamine. All patients were anesthetized with combined spinal/epidural anesthesia supplemented with sevoflurane 0.5% and nitrous oxide in oxygen. Postoperative pain was controlled by epidural infusion of the mixture of fentanyl (25 mcg.ml-1) and bupivacaine (3.8 mg.ml-1) at 2.1 ml.hr-1. Analgesic effect was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). VAS and VRS in group-K1 were significantly lower compared with those in group-C, while there was no difference between group-K2 and C. The incidence of side effects and additional use of analgesics were similar among the three groups. In conclusion, pre-incisional administration of ketamine reduced the postoperative pain, but post-incisional ketamine was not effective.
Hazama
K
K
Division of Anesthesia and Intensive Care Medicine, Hiroshima Prefectural Hiroshima Hospital.
Nakao
M
M
Kawaguchi
R
R
Nakatani
K
K
Nakagawa
M
M
Unetani
H
H
D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007044:Hysterectomy; D007262:Infusions, Intravenous; D007268:Injections, Epidural; D007430:Intraoperative Care; D007649:Ketamine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control*
D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D007649:Ketamine; D005283:Fentanyl; D002045:Bupivacaine