[Administration of ketamine during induction and maintenance of anaesthesia in postoperative pain prevention].
BACKGROUND
Carcinologic breast surgery is responsible of intermediary postoperative pain and needs 30% additional morphine. Now, morphine administration generates adverse effects. Publications about morphine saving effect of ketalar as antagonist of R-NMDA, administrated in perioperative increase are discussed.


OBJECTIVE
To evaluate the morphine saving effect of ketalar in carcinologic breast surgery.


METHODS
This phase III randomized and double-blind study includes 208 patients during 14 months. Surgery consisted in mastectomy with or without axillary lymph node dissection or lumpectomy with axillary lymph node dissection. Group K received ketalar at induction until the end of surgery. Group P (placebo) received physiologic serum in the same condition. During the postoperative first 48h, morphine's consumption and EN are measured.


RESULTS
No significant difference between two groups was observed. The EN evaluation and morphine consumption remained the same in the two groups. Our results did not find any benefit with use of ketamine between axillary lymph node dissection and no axillary lymph node dissection group.


CONCLUSIONS
Ketalar adjunction in our analgesic protocol did not induce significant morphine saving in carcinologic breast surgery.
Colombani
S
S
Département d'anesthésie-réanimation, centre régional de lutte contre cancer, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France. colombani@bergonie.org
Kabbani
Y
Y
Mathoulin-Pélissier
S
S
Gékière
J-P
JP
Dixmérias
F
F
Monnin
D
D
Lakdja
F
F
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000758:Anesthesia / Q000379:methods*; D001943:Breast Neoplasms / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000517:prevention & control*; D010919:Placebos; D011184:Postoperative Period
D000700:Analgesics; D010919:Placebos; D007649:Ketamine; D009020:Morphine