title: An intraoperative small dose of ketamine prevents remifentanil-induced postanesthetic shivering.
abstract: Patients undergoing gynecological laparotomy were randomized to receive either 0.5 mg/kg ketamine at induction of anesthesia followed by an infusion of 0.3 mg/kg/h until the end of surgery (ketamine group, n = 32), or an equivalent volume of normal saline (control group, n = 32). Anesthesia was maintained with IV propofol, a fixed infusion rate of remifentanil (0.25 μg/kg/min), and epidural ropivacaine. Postanesthetic shivering (PAS) was evaluated for 30 minutes after emergence. Intraoperative temperatures were similar between the 2 groups. The incidence of PAS was less frequent in the ketamine group (n = 2, 6%) compared with the control group (n = 12, 38%, P = 0.005). We conclude that, during the early recovery phase, intraoperative ketamine reduces remifentanil-induced PAS.
authors.affiliation: Department of Anesthesiology, Kansai Denryoku Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka 553-0003, Japan. nakasuji.masato@c3.kepco.co.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Nakasuji
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Nakamura
authors.forename: Norie
authors.initials: N
authors.lastname: Imanaka
authors.forename: Masuji
authors.initials: M
authors.lastname: Tanaka
authors.forename: Masataka
authors.initials: M
authors.lastname: Nomura
authors.forename: Soon Hak
authors.initials: SH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000762:Anesthesia Recovery Period; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007430:Intraoperative Care; D007564:Japan; D007649:Ketamine / Q000008:administration & dosage*; D010535:Laparoscopy; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D010880:Piperidines / Q000009:adverse effects*; D000077208:Remifentanil; D012768:Shivering / Q000187:drug effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D018691:Excitatory Amino Acid Antagonists; D010880:Piperidines; D007649:Ketamine; D000077208:Remifentanil