Effect of intraoperative infusion of low-dose ketamine on management of postoperative analgesia.
BACKGROUND
Use of opioids for perioperative analgesia is associated with sedation, respiratory depression and postoperative nausea and vomiting. N-methyl-D-aspartate receptor antagonist such as ketamine has both analgesic and antihyperalgesic properties. We studied the effect of intraoperative infusion of low-dose ketamine on postoperative analgesia and its management with opioids.


METHODS
A total of 80 patients scheduled for open cholecystectomy under general anesthesia were randomly allocated into two equal groups in a randomized double-blinded way. The general anesthetic technique was standardized in both groups. Group K patients (n = 40) received bolus of ketamine 0.2 mg/kg intravenously followed by an infusion of 0.1 mg/kg/h before skin incision, which was continued up to the end of surgery. Similar volume of saline was infused in Group C (n = 40). The pain score at different intervals and cumulative morphine consumption over 24 h was observed. Secondary outcomes such as hemodynamic parameters, patient satisfaction score and incidences of side effects were also recorded.


RESULTS
Intraoperative infusion of low-dose ketamine resulted in effective analgesia in first 6 h of the postoperative period, which was evident from reduced pain scores and reduced opioid requirements (P = 0.001). The incidence of side effects and patient satisfaction were similar in both groups.


CONCLUSIONS
Intraoperative low-dose ketamine infusion provides good postoperative analgesia while reducing need of opioid analgesics, which must be considered for better management of postoperative analgesia.
Department of Anaesthesiology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
Sarvjeet
S
Kaur
Depratment of Anaesthesiology, Government Medical College, Chandigarh, India.
Richa
R
Saroa
Department of Anaesthesiology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
Shobha
S
Aggarwal
Ketamine; morphine; postoperative analgesia