title: Effect of preinduction low-dose ketamine bolus on intra operative and immediate postoperative analgesia requirement in day care surgery: A randomized controlled trial.
abstract: BACKGROUND
  Availability of narcotics is an issue in developing countries, and low-dose ketamine offers an alternative to these drugs.
  
  
  OBJECTIVE
  The objective of this study is to evaluate the effect of a preemptive dose of low-dose ketamine on intra operative and the immediate postoperative analgesic requirements.
  
  
  METHODS
  Randomized double-blind control trial.
  
  
  METHODS
  This study has been performed in the operating rooms and postanesthesia care unit at Aga Khan University Hospital, Karachi, Pakistan.
  
  
  METHODS
  Totally, 60 adult American Society of Anesthesiologists I and II patients undergoing day care surgery were randomly allocated into two groups, Group A (ketamine group) and Group B (saline group).
  
  
  METHODS
  All patients underwent general anesthesia. Propofol 2 mg/kg was used as an induction agent; laryngeal mask airway (size 3 for females and 4 for males) was inserted. Following induction patients in Group A received ketamine 0.3 mg/kg and Group B saline bolus in a blinded manner. All patients were administered injection fentanyl 1 μg/kg as an analgesic and anesthesia was maintained with oxygen 40%, nitrous oxide 60% and isoflorane 1-2 minimum alveolar concentration. Patients breathed spontaneously on Lack circuit. Postoperatively rescue analgesia was provided with intravenous morphine 0.1 mg/kg when patient complained of pain.
  
  
  METHODS
  We observed analgesic effects of low-dose ketamine intra operatively and narcotic requirements in immediate postoperative period for day care surgeries.
  
  
  RESULTS
  There was no significant difference in demographic data in between groups. Saline group required more rescue analgesia (morphine) postoperatively (P < 0.001). No significant psychotomimetic symptoms were noted in either group.
  
  
  CONCLUSIONS
  Low-dose ketamine 0.3 mg/kg provided adequate co-analgesia with fentanyl 1 μg/kg and was effective in a reduction of morphine requirement in the postoperative phase with minimal adverse effects.
authors.affiliation: Department of Anesthesiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Khalid Maudood
authors.initials: KM
authors.lastname: Siddiqui
authors.affiliation: Department of Anesthesiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Fauzia Anis
authors.initials: FA
authors.lastname: Khan
keywords: Day care surgery; low-dose ketamine; postoperative analgesia