Effect of intravenous patient controlled ketamine analgesiaon postoperative pain in opium abusers.
BACKGROUND
Acutepostoperative pain is among the worst experience that patient scan undergo, and many analgesics have been used to suppress it; especially in chronic opium abusers. Ketamine is an N-methyl-D-aspartate antagonist analgesic, having both anesthetic and analgesic properties, which are not affected to the same extent in chronic opium abusers.


OBJECTIVE
In this study, we assessed the analgesic effects of ketamine added to morphine as a patient-controlled analgesia method for acute pain management, compared with a placebo, inchronic maleopium abusers.


METHODS
After institutional review board approval for ethical considerations, a randomized double-blinded placebo controlled clinical trial was conducted. A total of 140 male patients aged 18-65 years, undergoing orthopedic surgery, were entered into the study after matching inclusion and exclusion criteria. All patients received the same anesthesia method; while the first group received ketamine (1mg/mL) and morphine (0.5 mg/mL) as a patient-controlled analgesia (70 patients), the second group received morphine (0.5 mg/mL) plus normal saline (70 patients). P value less than 0.05 was considered statistically significant.


RESULTS
The ketamine and morphine group of patients experienced less postoperative pain and required less postoperative rescue analgesia. However, the unwanted postoperative side effects were nearly the same; although increased levels of postoperative nausea and vomiting were observed in the ketamine and morphine group.


CONCLUSIONS
This study demonstrated improved analgesic effects after using intravenous patient controlled analgesia with ketamine on postoperative pain in opium abusers.
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mastane
M
Dahi-Taleghani
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Benjamin
B
Fazli
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mahshid
M
Ghasemi
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Maryam
M
Vosoughian
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali
A
Dabbagh
Acute Pain; Drug Users; Ketamine; Opium