Double‐blind randomized placebo‐controlled trial of the effect of ketamine on postoperative morphine consumption in children following appendicectomy

Abstract

In this paediatric population intravenous ketamine did not have a morphine sparing effect. The increased incidence of side-effects, especially hallucinations, reported by patients given a ketamine infusion may limit the further use of postoperative ketamine in children.

Effects of perioperative intravenous low dose of ketamine on postoperative analgesia in children

“…Although ketamine effects have been widely debated in adults, paediatric data are confidential and controversial [14][15][16][17]20,21]. Our findings are consistent with those of some other studies in children [14][15]17].…”

“…Pain scores and analgesic consumption were reduced in only two studies [17,20]. Moreover, psychomimetic effects such as hallucinations were more important in the ketamine group [14]. In a recent study, an intravenous bolus (0.2 mg kg À1 ) followed by an intraoperative infusion (5 mg kg À1 min À1 ) of S-ketamine during major urological surgery improved pain scores only during the first postoperative hour and delayed the first morphine request [16].…”

“…Three studies analysed the effects of a single bolus of 100 mg kg À1 [20], 150 mg kg À1 [15] or 500 mg kg À1 [17] of ketamine for tonsillectomy. A fourth study evaluated the influence of a 500 mg kg À1 bolus of ketamine eventually followed by a postoperative infusion (5.7 mg kg À1 day À1 ) for appendectomy [14]. Pain scores and analgesic consumption were reduced in only two studies [17,20].…”

“…Ketamine reduced both morphine consumption and pain scores in several studies [4][5][6][7][8][9][10][11][12][13]. There are only a few studies in the paediatric population with conflicting results [14][15][16][17]. The aim of this randomized, prospective, double-blinded, placebo-controlled study was therefore to determine whether intraoperative and postoperative low-dose ketamine reduces postoperative pain scores in children.…”

Evaluation of a Low Dose Ketamine in Post Tonsillectomy Pain Relief: A Randomized Trial Comparing Intravenous and Subcutaneous Ketamine in Pediatrics

“…Studies in children are controversial. Some authors do not confirm the preemptive effect of ketamine on the preoperative analgesic consumption during the first hours of postoperative period in children (7,15,16). Our study showed that intravenous and subcutaneous administration of low dose ketamine reduced not only the post-operative pain score, but also analgesic requirement after tonsillectomy.…”