title: The effect of a small dose of ketamine  on postoperative analgesia and cytokine changes after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  In this study we assesed the effect of a small dose of ketamine on the production of TNFα, IL-1β and IL-6 and the postoperative pain in patients undergoing laparoscopic cholecystectomy.
  
  
  METHODS
  Fifty patients undergoing laparoscopic cholecystectomy were randomized in two equal groups. Patients in the ketamine group after induction in anesthesia received ketamine--025 mg/kg(-1). At the same time patients from the control group received sodium chloride. Postoperatively, the pain was assessed with VAS at periods of 30 min at 1, 2, 4, 8, 18, 24 and 48 hours. TNFα, IL-1β and IL-6 were evaluated before surgery at 4, 18 and 24h after the operation.
  
  
  RESULTS
  Differences of mean values of TNFα and IL-1β between the two groups in the postoperative period were not significant. Mean values of IL-6 in the investigated group A were significantly lower than the mean values of IL-6 in the investigated group B after the 4th hour (p=0.00990), after the 18th hour (p=0.00133) and as after the 24th hour following surgery (p=000860). the difference in pain intensity according to the VAS scale was also statistically significantly smaller in group A after 30 min, 1,2,8 and 12 hours after surgery.
  
  
  CONCLUSIONS
  The addition of a small-dose of ketamine in patiens undergoing laparoscopic cholecystectomy resulted in attenuation of secretion of TNFα, IL-1β, IL-6 and reduction of postoperative pain.
authors.affiliation: University Anaesthesia Clinic, Reanimation and Intensive Care, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, R. Macedonia.
authors.forename: A
authors.initials: A
authors.lastname: Kartalov
authors.forename: D
authors.initials: D
authors.lastname: Trajkov
authors.forename: M
authors.initials: M
authors.lastname: Spiroski
authors.forename: Z
authors.initials: Z
authors.lastname: Nikolova Todorova
authors.forename: B
authors.initials: B
authors.lastname: Kuzmanovska
authors.forename: V
authors.initials: V
authors.lastname: Dzambazovska Trajkovska
authors.forename: M
authors.initials: M
authors.lastname: Zdravkovska
authors.forename: Z
authors.initials: Z
authors.lastname: Karadzov
authors.forename: Gj
authors.initials: G
authors.lastname: Jota
authors.forename: J
authors.initials: J
authors.lastname: Nojkov
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism*; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D000700:Analgesics; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007649:Ketamine