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. 2015 Oct-Dec;9(4):422-7.
doi: 10.4103/1658-354X.159468.

Effect of preinduction low-dose ketamine bolus on intra operative and immediate postoperative analgesia requirement in day care surgery: A randomized controlled trial

Khalid Maudood Siddiqui  1 , Fauzia Anis Khan  1
Affiliations

Effect of preinduction low-dose ketamine bolus on intra operative and immediate postoperative analgesia requirement in day care surgery: A randomized controlled trial

Khalid Maudood Siddiqui et al. Saudi J Anaesth. 2015 Oct-Dec.

Abstract

Background: Availability of narcotics is an issue in developing countries, and low-dose ketamine offers an alternative to these drugs.

Objective: The objective of this study is to evaluate the effect of a preemptive dose of low-dose ketamine on intra operative and the immediate postoperative analgesic requirements.

Design: Randomized double-blind control trial.

Settings: This study has been performed in the operating rooms and postanesthesia care unit at Aga Khan University Hospital, Karachi, Pakistan.

Materials and methods: Totally, 60 adult American Society of Anesthesiologists I and II patients undergoing day care surgery were randomly allocated into two groups, Group A (ketamine group) and Group B (saline group).

Intervention: All patients underwent general anesthesia. Propofol 2 mg/kg was used as an induction agent; laryngeal mask airway (size 3 for females and 4 for males) was inserted. Following induction patients in Group A received ketamine 0.3 mg/kg and Group B saline bolus in a blinded manner. All patients were administered injection fentanyl 1 μg/kg as an analgesic and anesthesia was maintained with oxygen 40%, nitrous oxide 60% and isoflorane 1-2 minimum alveolar concentration. Patients breathed spontaneously on Lack circuit. Postoperatively rescue analgesia was provided with intravenous morphine 0.1 mg/kg when patient complained of pain.

Main outcome measures: We observed analgesic effects of low-dose ketamine intra operatively and narcotic requirements in immediate postoperative period for day care surgeries.

Results: There was no significant difference in demographic data in between groups. Saline group required more rescue analgesia (morphine) postoperatively (P < 0.001). No significant psychotomimetic symptoms were noted in either group.

Conclusion: Low-dose ketamine 0.3 mg/kg provided adequate co-analgesia with fentanyl 1 μg/kg and was effective in a reduction of morphine requirement in the postoperative phase with minimal adverse effects.

Keywords: Day care surgery; low-dose ketamine; postoperative analgesia.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Flow diagram of patient distribution
Figure 2
Figure 2
Comparison of mean heart rate between ketamine group (•) and saline group (o). The symbol *indicates a significant difference from baseline and †indicates intergroup significant difference
Figure 3
Figure 3
Comparison of mean systolic blood pressure between ketamine group (•) and saline group (o). The symbol *indicates a significant difference from baseline and †indicates intergroup significant difference
Figure 4
Figure 4
Comparison of mean diastolic blood pressure e between ketamine group (•) and saline group (o). The symbol *indicates a significant difference from baseline and †indicates intergroup significant difference
Figure 5
Figure 5
Comparison of mean blood pressure between ketamine group (•) and saline group (o). The symbol *indicates a significant difference from base line and† indicates intergroup significant difference
Figure 6
Figure 6
Comparison of severity of pain between ketamine group (formula image) and saline group (◻◻)
See this image and copyright information in PMC

References

    1. Rabiner EA. Imaging of striatal dopamine release elicited with NMDA antagonists: Is there anything there to be seen? J Psychopharmacol. 2007;21:253–8. - PubMed
    1. Dickenson AH. Combination therapy in analgesia; seeking synergy. Curr Opin Anesthesiol. 1993;6:861–5.
    1. Hodges SC, Mijumbi C, Okello M, McCormick BA, Walker IA, Wilson IH. Anesthesia services in developing countries: Defining the problems. Anesthesia. 2007;62:4–11. - PubMed
    1. Launo C, Bassi C, Spagnolo L, Badano S, Ricci C, Lizzi A, et al. Preemptive ketamine during general anesthesia for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Minerva Anestesiol. 2004;70:727–34. - PubMed
    1. Sunder RA, Toshniwal G, Dureja GP. Ketamine as an adjuvant in sympathetic blocks for management of central sensitization following peripheral nerve injury. J Brachial Plex Peripher Nerve Inj. 2008;3:22. - PMC - PubMed