title: [Effects of general anesthesia using ketamine and remifentanil on postoperative pain management for patients undergoing laparotomy].
abstract: BACKGROUND
  Co-administration of ketamine and remifentanil may offer preemptive analgesia and prevention of opioid-induced hyperalgesia, resulting in reduction of postoperative pain.
  
  
  METHODS
  We retrospectively analyzed data concerning anesthetic management and postoperative pain management in 19 adult patients undergoing elective laparotomy with general anesthesia using ketamine and remifentanil.
  
  
  RESULTS
  Ketamine and remifentanil were co-administered for both induction and maintenance of general anesthesia. Preoperative and total doses of ketamine were 1.4+/-0.5 and 1.9+/-0.4 mg x kg(-1). Infusion rate of remifentanil at the beginning of surgery was 0.24+/-0.02 microg x kg(-1) x min(-1), and minimal and maximal rate were 0.06+/-0.03 and 0.26+/-0.03 microg x kg(-1) min(-1). Pentazocine and nonsteroidal anti-inflammatory drugs (NSAIDs) were used for postoperative pain management. Consumption of pentazocine was 0.51+/-0.33 mg x kg(-1) on 1st postoperative day (1POD), and NSAIDs were co-administered on 1POD for 3 patients. Most patients could stand up and walk on 1POD.
  
  
  CONCLUSIONS
  Results in this study suggest that anesthetic management using ketamine and remifentanil may be useful for postoperative pain management, probably by preemptive analgesic effects of both agents and preventive effects of ketamine against opioid-induced hyperalgesia.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, The University of Tokyo, Tokyo.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kitamura
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Imai
authors.forename: Nagara
authors.initials: N
authors.lastname: Ohno
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Muroya
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogawa
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000517:prevention & control; D007649:Ketamine; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D010423:Pentazocine / Q000008:administration & dosage; D010880:Piperidines; D000077208:Remifentanil; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010880:Piperidines; D007649:Ketamine; D000077208:Remifentanil; D010423:Pentazocine