title: The effect of addition of ketamine to lidocaine on postoperative pain in rhinoplasties.
abstract: OBJECTIVE
  The objective of this study was to examine the effect of addition of subanesthetic doses of ketamine to an epinephrine-lidocaine solution on postoperative pain, analgesic use, and patient comfort during rhinoplasties.
  
  
  METHODS
  Ninety patients were randomly divided into three groups: Group L, lidocaine with epinephrine; Group K, lidocaine with epinephrine plus ketamine; and Group S (control group), physiological saline solution with epinephrine. The local anesthetic solution was injected as preincisionally with intranasal submucosal infiltration following induction of general anesthesia. We evaluated visual pain score, analgesic demand, Wilson sedation score, and antiemetic demand at 5, 15, and 30 min and 1, 2, 4, 6, 8, 16, and 24 h after the operation. The patient satisfaction score was checked 24 h after the operation.
  
  
  RESULTS
  Visual pain score was significantly reduced in Group K in comparison with the other groups and this group did not need any rescue analgesics (P < 0.05). The postoperative patient satisfaction scores were highest in Group K compared with the other groups (P < 0.05).
  
  
  CONCLUSIONS
  Addition of ketamine solution to lidocaine for infiltration block during rhinoplasty was successful in decreasing pain during postoperative periods and reducing analgesic consumption during the first 24 h after the operation.
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Mukadder
authors: M
authors: Şanli
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Nurçin
authors: N
authors: Gülhaş
authors: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Bilge Türk
authors: BT
authors: Bilen
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Gülay
authors: G
authors: Erdoğan Kayhan
authors: Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Muharrem
authors: M
authors: Uçar
authors: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Ahmet Hamdi
authors: AH
authors: Aytekin
authors: Department of Biostatistics, Faculty of Medicine, İnönü University, Malatya, Turkey.
authors: Saim
authors: S
authors: Yoloğlu
mesh_terms: D000779:Anesthetics, Local; D004311:Double-Blind Method; D006801:Humans; D007649:Ketamine; D008012:Lidocaine; D010149:Postoperative Pain; D012225:Rhinoplasty
chemical_list: D000779:Anesthetics, Local; D007649:Ketamine; D008012:Lidocaine
keywords: Ketamine; lidocaine; postoperative pain; rhinoplasty