Preemptive Use of Ketamine on Post Operative Pain of Appendectomy

Behdad, Akbar; Hosseinpour, Mehrdad; Khorasani, Parastoo

doi:10.3344/kjp.2011.24.3.137

Cited by 31 publications

(34 citation statements)

References 25 publications

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“…They explained that this was because when a high dose of ketamine is administered, it can reach a relatively higher plasma concentration to suppress NMDA-R activation compared to that of low-dose administration. However, there are other reports in which 0.5 mg/kg of ketamine was helpful for relieving postoperative pain after abdominal surgery [18,19], and even that the analgesic requirement after cesarean section was reduced with administration of a low dose of 0.15 mg/kg [10,11]. There is also a report that the morphine requirement was not different in three groups of cesarean section patients administered 0.25, 0.5, or 1.0 mg/kg of ketamine [20]; thus, it is possible that the preemptive analgesic effect of ketamine is not dose dependent.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia

et al. 2013

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BackgroundKetamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section.MethodsSpinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-µg fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively.ResultsSignificantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively.ConclusionsIntraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section.

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Section: Discussionmentioning

confidence: 99%

The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia

et al. 2013

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“…Four studies [51–54] assessed a single dose of low‐dose ketamine using a reduction of pain as their first endpoint. This represents 251 patients, 141 of whom received ketamine.…”

Section: Methodsmentioning

confidence: 99%

“…Out of the four studies, two [51,53] reported a reduction of opioid consumption along with a reduction of pain scores for 24 hours postoperative. Safavi et al.…”

Section: Methodsmentioning

confidence: 99%

“…Giving a single dose of 0.5 mg/kg, Behdad et al. [53] reported a 70% reduction of pethidine consumption at 24 hours postoperative (ketamine = 0.6 mg vs placebo = 2.0 mg) and reduced VAS pain scores (ketamine = 1.3 vs placebo = 1.8 at 24 hours postoperative and ketamine = 4.5 vs placebo = 6.6 at the first time of complete consciousness on a 10‐point VAS).…”

Section: Methodsmentioning

confidence: 99%

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The Use of Intravenous Infusion or Single Dose of Low-Dose Ketamine for Postoperative Analgesia: A Review of the Current Literature

Jouguelet-Lacoste¹,

Colla²,

Schilling³

et al. 2015

Pain Med

210

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Thirty-nine clinical trials assessed a continuous infusion or a bolus of low-dose ketamine for postoperative analgesia using reduction of pain scores or reduction of the opioid consumption as the primary endpoint. The mean reduction of opioid consumption when using low-dose i.v. infusion ketamine (infusion rate less than 1.2 mg/kg/h) is 40%. Ketamine also reduces pain scores, but the amplitude of the effect is less clear. No major complications have been reported with low-dose i.v. infusion of ketamine up to 48 hours following surgery.

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“…Several reports have reported varying results depending on the type of surgery. In gynecologic laparoscopic surgery, laparoscopic cholecystectomy and laparoscopic appendectomy, ketamine has preemptive analgesic effects, as seen during the early postoperative period [13,23,24]. In contrast, there are some reports showing that ketamine has no preemptive effect in cesarean sections and arthroscopic shoulder surgery [25,26].…”

Section: Discussionmentioning

confidence: 99%

The effect of preemptive intravenous ketamine on postoperative pain in patients undergoing arthroscopic rotator cuff repair with intra articular ropivacaine injection

et al. 2016

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:A low dose of ketamine can be an effective preemptive analgesic by preventing central sensitization when administered before surgical trauma. In this study, we assessed the preemptive analgesic effect of low-dose ketamine administered intravenously to patients undergoing arthroscopic rotator cuff repair with intra articular ropivacaine injection. Methods: This randomized, double-blinded study included fifty-six patients scheduled for elective arthroscopic rotator cuff repair. Normal saline (group C) or 0.5 mg/kg of ketamine (group K) was injected intravenously before the skin incision. An intra articular injection using 20 ml of 0.75% ropivacaine was performed in both groups just before wound closure by the surgeon at the end of the surgery. Postoperative pain was assessed by the numeric rating scale (NRS) in the post-anesthesia care unit (PACU) and at 12, 24, and 48 hours postoperatively. The total dose of fentanyl consumption and side effects were recorded. Results: There were no significant differences between the C and K groups for the NRS of pain in the PACU and at 12, 24, and 48 hours after the surgery. In addition, there was also no significant difference in total fentanyl consumption between the two groups. Conclusions: Preemptive ketamine did not reduce preemptive pain scores and fentanyl consumption in patients who underwent arthroscopic rotator cuff repair with intra articular local anesthetic injection. Therefore, more aggressive and multimodal pain control is required in patients undergoing arthroscopic shoulder surgery regardless of the use of preemptive intravenous ketamine injection.

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Preemptive Use of Ketamine on Post Operative Pain of Appendectomy

Cited by 31 publications

References 25 publications

The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia

The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia

The Use of Intravenous Infusion or Single Dose of Low-Dose Ketamine for Postoperative Analgesia: A Review of the Current Literature

The effect of preemptive intravenous ketamine on postoperative pain in patients undergoing arthroscopic rotator cuff repair with intra articular ropivacaine injection

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