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[Pre-incisional administration of ketamine reduced the postoperative pain]
K Hazama1, M Nakao, R Kawaguchi
1Division of Anesthesia and Intensive Care Medicine, Hiroshima Prefectural Hiroshima Hospital.
This study was designed to examine the postoperative analgesic effect of pre-/post-incisional administration of ketamine. Thirty-nine female patients scheduled for transabdominal hysterectomy were randomly allocated into 3 groups. Patients in group-K1 (n = 13) received intravenous ketamine 100 mg before surgical incision and patients in group-K2 (n = 13) received the same after laparotomy. Group-C (n = 13) did not receive any ketamine. All patients were anesthetized with combined spinal/epidural anesthesia supplemented with sevoflurane 0.5% and nitrous oxide in oxygen. Postoperative pain was controlled by epidural infusion of the mixture of fentanyl (25 mcg.ml-1) and bupivacaine (3.8 mg.ml-1) at 2.1 ml.hr-1. Analgesic effect was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). VAS and VRS in group-K1 were significantly lower compared with those in group-C, while there was no difference between group-K2 and C. The incidence of side effects and additional use of analgesics were similar among the three groups. In conclusion, pre-incisional administration of ketamine reduced the postoperative pain, but post-incisional ketamine was not effective.
This study was designed to examine the postoperative analgesic effect of pre-/post-incisional administration of ketamine. Thirty-nine female patients scheduled for transabdominal hysterectomy were randomly allocated into 3 groups. Patients in group-K1 (n = 13) received intravenous ketamine 100 mg before surgical incision and patients in group-K2 (n = 13) received the same after laparotomy. Group-C (n = 13) did not receive any ketamine. All patients were anesthetized with combined spinal/epidural anesthesia supplemented with sevoflurane 0.5% and nitrous oxide in oxygen. Postoperative pain was controlled by epidural infusion of the mixture of fentanyl (25 mcg.ml-1) and bupivacaine (3.8 mg.ml-1) at 2.1 ml.hr-1. Analgesic effect was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). VAS and VRS in group-K1 were significantly lower compared with those in group-C, while there was no difference between group-K2 and C. The incidence of side effects and additional use of analgesics were similar among the three groups. In conclusion, pre-incisional administration of ketamine reduced the postoperative pain, but post-incisional ketamine was not effective.