| The Effects of the Intravenous Continuous Infusion of Low-dose Ketamine on Postoperative Pain after Total Intravenous Anesthesia. |
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Yun Jin Kim, Hee Jung Baik, Jong Hak Kim |
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Department of Anesthesiology, College of Medicine, Ewha Womans University, Seoul, Korea. baikhj@ewha.ac.kr |
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| Abstract |
BACKGROUND
Ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, may prevent central sensitization and result in preemptive analgesia when administered before surgically induced trauma. The goal of this study was to determine whether intravenous low dose ketamine would reduce postoperative pain and cumulative analgesic requirements after total intravenous anesthesia (TIVA) with propofol and fentanyl.
METHODS
The thirty-four patients undergoing total abdominal hysterectomy were randomly allocated to according to anesthetic agent to a propofol-fentanyl-N2O (60%)-O2 (40%) group (group PFN) or a propofol-fentanyl-ketamine-O2 (40%) group (group PFK); 0.3 mg/kg of ketamine initially during induction followed by a continous infusion at 0.15 mg/kg/h. Propofol and fentanyl were continuously administered using target controlled infusion (TCI).
Intravenous patient-controlled analgesia (IV-PCA) using a fentanyl-ketorolac mixture was started in all patients after full recovery in a postanesthetic care unit (PACU). Verbal numerial scale (VNS) pain scores, cumulative total analgesic consumptions, and side effects were recorded immediately before and at 1, 3, 6, 12, 24, and 48 h after IV PCA.
RESULTS
No significant intergroup differences were seen in the VNS pain scores and in side effects during entire study period. But, patients in the PFK group had significantly lower total analgesic consumptions at 48 h after IV PCA. No significant differences were observed between the two groups in terms of side effects.
CONCLUSIONS
Intravenous low dose ketamine during TIVA with propofol and fentanyl did not reduce postoperative pain scores, but did reduce total analgesic requirement at 48 h after IV PCA. |
| Key Words:
fentanyl; ketamine; intravenous patient-controlled analgesia; preemptive analgesia; propofol; total intravenous anesthesia |
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