Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy
Harsimran Singh1, Sandeep Kundra, Rupinder M Singh
1Department of Anesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Journal of Anaesthesiology, Clinical Pharmacology
|November 20, 2013
Summary
Preemptive ketamine significantly reduced postoperative pain and analgesic needs in laparoscopic cholecystectomy patients. A 0.5 mg/kg dose is optimal, offering benefits without adverse effects.
Area of Science:
- Anesthesiology
- Pain Management
- Pharmacology
Background:
- Preemptive analgesia aims to mitigate perioperative central sensitization.
- N-methyl d-aspartate (NMDA) receptor antagonists show potential in preventing central neuroplasticity.
Purpose of the Study:
- To evaluate the efficacy of preemptive ketamine in reducing postoperative pain after laparoscopic cholecystectomy.
- To determine the optimal dose of ketamine for preemptive analgesia.
Main Methods:
- A randomized study involving 80 patients undergoing laparoscopic cholecystectomy.
- Four groups received varying doses of ketamine (1.00, 0.75, 0.50 mg/kg) or saline intravenously 30 minutes pre-incision.
- Postoperative pain, analgesic consumption, and adverse events were assessed over 24 hours.
Main Results:
- Ketamine groups (A, B, C) exhibited significantly lower postoperative pain scores compared to the saline group (D).
- Groups A, B, and C required significantly less opioid analgesia postoperatively.
- The 0.50 mg/kg ketamine dose (Group C) showed efficacy without significant adverse effects or hemodynamic changes.
Conclusions:
- Preemptive ketamine administration effectively reduces postoperative pain and analgesic requirements in laparoscopic cholecystectomy.
- A ketamine dose of 0.5 mg/kg is identified as optimal for preemptive analgesia, balancing efficacy and safety.
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