[Addition of ketamine infusion to patient controlled analgesia with intravenous morphine after abdominal hysterectomy]

Abstract

In our study we aimed to reduce postoperative morphine consumption, prevent adverse effects of morphine, and improve analgesic quality via adding analgesic doses of ketamine infusion to intravenous morphine-patient controlled analgesia (PCA). After local ethics committee approval, 45 patients scheduled for total abdominal hysterectomy were included in the study. In the postoperative period the patients were separated into two groups randomly. After starting morphine-PCA in both groups, one group received ketamine infusion (Group K: n= 22), while the other group received saline infusion (Group S: n= 23) for 24 hours. There was no significant difference between the postoperative systolic and diastolic arterial pressures, heart rate and respiratory rate values. Visual Analogue Scale and Verbal Rating Scale measures was significantly lower in Group K (p<0.01). Total morphine consumption was higher in Group S (p<0.05). Sedation scores were significantly lower in Group K (p<0.05). When adverse effects were evaluated we found that nausea was higher in Group S (p<0.05), while there was no difference in the other side effects (p>0.05). Patient satisfaction was better in the 24th and 48th hours in Group K and was found to be statistically significant (p<0.05). Our results suggest that ketamine infusion added to opioids for postoperative analgesia, reduces total opioid requirement and prevents side effects.