Analgesia with Low-Dose S(+)-ketamine in Laparoscopic Cholecystectomy: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Mendes, Florentino Fernandes; Luft, Ana Paula; Telöken, Cláudio

doi:10.4172/2155-6148.1000133

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…in their study found that perioperative use of S (+)-ketamine is better than intraoperative use in patients undergoing major abdominal surgery. [ 20 ] This finding disagrees with our observation probably due to the type of surgery. Major abdominal surgery produces more tissue trauma as compared to laparoscopic gynecological surgery.…”

Section: Discussioncontrasting

confidence: 99%

“…Unlike our study where ketamine is the sole analgesic agent, additional analgesic agents such as paracetamol, tramadol, ketoprofen, and/or epidural analgesia were used in these studies; hence, analgesic effect can obtained cannot be attributed to ketamine only. [ 19 20 ] Argiriadou et al . studied preincisional and repeated intraoperative use of ketamine in patients undergoing major abdominal surgery with epidural and general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of low-dose ketamine as sole analgesic agent in maintaining analgesia and intraoperative hemodynamics during laparoscopic gynecological surgeries

et al. 2017

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Background:Ketamine, in low doses, is known to possess intense analgesic properties. The available literature shows wide variation regarding the time and dose of administration of ketamine during surgery.Aim:The aim of this study was to evaluate the effect of intraoperative administration of ketamine when used as sole analgesic in low doses, on hemodynamics and postoperative analgesia in patients undergoing laparoscopic gynecological surgery and compared on the basis of duration of surgery.Settings and Design:This prospective, observational study was conducted from July to December 2015, over a period of 6 months in a tertiary care medical college and hospital.Materials and Methods:Seventy patients between 23 and 55 years planned for laparoscopic gynecological surgery were recruited. Ketamine was given in a dose of 0.5 mg/kg preoperatively and then repeated every ½ hourly in a dose of 0.25 mg/kg throughout the surgery. Hemodynamic parameters, time to the first rescue analgesia and complications were recorded for the first 8 h. Statistical evaluation was done and result expressed as percentage. Paired t-test was employed for the comparison of numerical variables within the group.Results:Seventy percent of the patients did not require any postoperative rescue analgesia during the first 8 h after surgery. None of the patients complained of pain immediately after extubation, and 16% of the patients had minor postoperative complications. The intraoperative hemodynamic profile was significantly altered. Duration of surgery and dose of ketamine required did not affect the duration of analgesia.Conclusion:Ketamine in low dose proved to be an efficacious analgesic even in the long duration laparoscopic gynecological surgeries. It stabilizes intraoperative hemodynamics thereby reducing the requirement of other anesthetic and antihypertensive agents.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of low-dose ketamine as sole analgesic agent in maintaining analgesia and intraoperative hemodynamics during laparoscopic gynecological surgeries

et al. 2017

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“…Recent analgesic techniques use analgesic with different mechanisms of action to improve postoperative pain relief and reduce opioids requirements, and opioids-related adverse effects. Studies suggest that the use of low dose of S(+)-ketamine, a nonspecific blocker of NMDA [18] receptors, may reduce the need for opioids and opioid-related adverse effects .The purpose of this study was to evaluate in a double blind randomized trial the analgesic and adverse effects of S(+)-ketamine in a patients undergoing laparoscopic cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

Anesthesia and Intensive Care

Nayak¹,

Qurasani²,

Reddy³

2013

J Anesthe Clinic Res

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Ketamine Infusion for Management of Early Postoperative Pain Following Elective Laparoscopic Cholecystectomy: Assessment of Optimum Dose

Magda

Laha

et al. 2021

ijsr

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Background: This study is aimed to assess an optimal dose of ketamine infusion for management of early postoperative pain in elective laparoscopic cholecystectomy. Intensity of pain, requirement of rescue analgesics and tness to discharge were assessed during immediate postoperative period. Methodology: Randomised controlled prospective clinical trial was conducted in 140 patients of laparoscopic cholecystectomy and, allocated in four groups of 35 each. Standard anaesthetic regimen was used in all patients, using propofol for induction, atracurium for muscle relaxation and isourane for maintenance of anaesthesia. Continuous infusion of the test drug was administered by intravenous cannula placed in alternate hand -1 -1 from start of port placement till wound closure. Group K1, K2 and K3 received an infusion of ketamine hydrochloride at a rate of 20 µg kg min , 30 -1 -1 -1 -1 µg kg min and, 40 µg kg min respectively, while Group N received normal saline. Postoperative pain score, requirement of rescue analgesia, degrees of sedation and postoperative cognitive function were examined postoperatively. Results: -1 Visual analog scale score ≥ 4 was considered signicant pain and, rescue analgesic injection diclofenac sodium 75mg kg was administered. Duration of analgesia was 130.71 ± 82.41, 457.14 ± 150.373, 520.97 ± 189.338 and, 524.83 ± 141.436 minutes in group N, K1, K2 and K3 respectively. Out of 35 patients 28, 4, 0 and, 0 patients required three doses of diclofenac sodium in 24 hours in N, K1, K2 and K3 group respectively. Conclusions: -1 -1 Continuous infusion of ketamine hydrochloride at a rate of 30 µg kg min during intraoperative period provide effective pain relief during early postoperative period without inuencing cognitive function of the patients.

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Analgesia with Low-Dose S(+)-ketamine in Laparoscopic Cholecystectomy: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Cited by 3 publications

References 29 publications

Efficacy of low-dose ketamine as sole analgesic agent in maintaining analgesia and intraoperative hemodynamics during laparoscopic gynecological surgeries

Efficacy of low-dose ketamine as sole analgesic agent in maintaining analgesia and intraoperative hemodynamics during laparoscopic gynecological surgeries

Anesthesia and Intensive Care

Ketamine Infusion for Management of Early Postoperative Pain Following Elective Laparoscopic Cholecystectomy: Assessment of Optimum Dose

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