Bowel function after bowel surgery: morphine with ketamine or placebo; a randomized controlled trial pilot study.

Area of Science:

• Anesthesiology
• Gastroenterology
• Surgical Recovery

Background:

• Morphine slows intestinal motility post-surgery.
• Ketamine may mitigate morphine-induced ileus without increasing pain.
• Combining ketamine with morphine could accelerate bowel function recovery.

Purpose of the Study:

• To evaluate the efficacy of ketamine in combination with morphine for improving bowel function after bowel resection surgery.
• To assess the impact of ketamine on post-operative pain control and morphine consumption.

Main Methods:

• Double-blind randomized controlled trial involving 42 patients undergoing bowel resection.
• Comparison of saline placebo versus ketamine, both co-administered with patient-controlled analgesia morphine.
• Assessment of bowel function via auscultation, flatus/stool passage, and oral intake tolerance; pain measured by visual analog scale.

Main Results:

• No significant difference in bowel function recovery, pain scores, or morphine usage between ketamine and placebo groups.
• Ketamine administration resulted in hallucinations in 6 of 19 patients (P = 0.018), with no hallucinations in the placebo group.
• The study did not demonstrate ketamine's efficacy in hastening bowel function or reducing pain.

Conclusions:

• Low-dose ketamine is not effective for accelerating bowel function return or managing post-operative pain following bowel resection.
• Ketamine use was associated with a significant incidence of hallucinations.
• The side effect profile of hallucinations may limit the clinical utility of ketamine in this setting.