title: Does intravenous ketamine enhance analgesia after arthroscopic shoulder surgery with ultrasound guided single-injection interscalene block?: a randomized, prospective, double-blind trial.
abstract: Ketamine has anti-inflammatory, analgesic and antihyperalgesic effect and prevents pain associated with wind-up. We investigated whether low doses of ketamine infusion during general anesthesia combined with single-shot interscalene nerve block (SSISB) would potentiate analgesic effect of SSISB. Forty adult patients scheduled for elective arthroscopic shoulder surgery were enrolled and randomized to either the control group or the ketamine group. All patients underwent SSISB and followed by general anesthesia. During an operation, intravenous ketamine was infused to the patients of ketamine group continuously. In control group, patients received normal saline in volumes equivalent to ketamine infusions. Pain score by numeric rating scale was similar between groups at 1, 6, 12, 24, 36, and 48 hr following surgery, which was maintained lower than 3 in both groups. The time to first analgesic request after admission on post-anesthesia care unit was also not significantly different between groups. Intraoperative low dose ketamine did not decrease acute postoperative pain after arthroscopic shoulder surgery with a preincisional ultrasound guided SSISB. The preventive analgesic effect of ketamine could be mitigated by SSISB, which remains one of the most effective methods of pain relief after arthroscopic shoulder surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Jae Hee
authors.identifier: 0000-0002-1993-1687
authors.initials: JH
authors.lastname: Woo
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Youn Jin
authors.identifier: 0000-0001-9189-5839
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Hee Jung
authors.identifier: 0000-0002-8877-0274
authors.initials: HJ
authors.lastname: Baik
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Jong In
authors.identifier: 0000-0002-8231-7161
authors.initials: JI
authors.lastname: Han
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Rack Kyung
authors.identifier: 0000-0003-4216-1665
authors.initials: RK
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage*; D001182:Arthroscopy; D001917:Brachial Plexus / Q000000981:diagnostic imaging; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012782:Shoulder / Q000601:surgery*; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D000700:Analgesics; D007649:Ketamine
keywords: Interscalene Nerve Block; Ketamine; Pain, Postoperative; Shoulder Surgery