[Pre-emptive analgesia with intravenous ketamine reduces postoperative pain in young patients after appendicectomy: a randomized control study].
Thirty-six young patients (12-17 years old) for appendicectomy were randomly allocated to receive ketamine 0.5 mg.kg-1 (K 0.5 group; n = 12), ketamine 1.0 mg.kg-1 (K 1.0 group; n = 12), or lactated Ringer's solution 5 ml (control group; n = 12), which was administered intravenously before incision. After the surgery, all patients received a nonsteroidal anti-inflammatory drug (NSAID) without limitation as requested by the patient. Pain scores at rest and on movement were assessed at 6-10 hr, 24 hr, and 48 hr post-operatively using a visual analogue scale. The frequency at which NSAID was given for postoperative analgesia in the first 48 hr after the surgery was recorded. The patients in the K 0.5 and K 1.0 groups had significantly lower pain scores at rest 6-10 hr postoperatively than the patients in the control group (P < 0.05). Additionally, the patients in the K 1.0 group had a significantly lower pain score on movement 6-10 and 48 hr postoperatively than those in the control group (P < 0.05). The K 0.5 and K 1.0 groups each used significantly less NSAID during the 48-hr postoperative period than the control group (P < 0.05). Intravenous administration of ketamine before incision was associated with decreases in pain at rest 6-10 hr postoperatively and a reduction in NSAID requirement after appendicectomy. Administration of ketamine 1.0 mg.kg-1 prior to incision was superior to administration of 0.5 mg.kg-1 in relief of pain on movement after the surgical procedure.
Kakinohana
M
M
Division of Anesthesia, Okinawa Prefectural Miyako Hospital, Hirara.
Hasegawa
A
A
Taira
Y
Y
Okuda
Y
Y
D000293:Adolescent; D000700:Analgesics / Q000008:administration & dosage*; D000768:Anesthesia, General; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001062:Appendectomy; D002648:Child; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D011300:Preoperative Care
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007649:Ketamine