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KMID : 0390320080180010306
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Chungbuk Medical Journal
2008 Volume.18 No. 1 p.306 ~ p.313
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The Effect of Epidural Ketamine used with Patient-Controlled Analgesia on Postoperative Pain
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Kang Hoon
Park Sang-Hi
Lee Dong-Hun
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Abstract
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Purpose: Acute pain can be abolished by intravenous administration of ketamine in doses insufficient to induce anesthesia. Therefore we designed this study to see if this subanesthetic dosage of ketamine administered epidurally with patient-controlled analgesia (PCA) after abdominal surgery can also provide sufficient analgesic effect on postoperative pain.
Materials & Method: 20 consecutive patients were allocated randomly to receive either ketamine (n=10) or placebo (n=10) for pain relief after surgery. At 30 minutes before the end of surgery patients were attached to an PCA infusor programmed to epidurally deliver same amount of placebo or ketamine 3-5 mg/h (72-120 mg/day) in combination with background PCA regimen composed of bupivacaine, morphine, fentanyl etc for 48 hours postoperatively. Patients were evaluated for pain on ten-point Verbal Analogue Scale (VAS) and nausea on a four-point scale at 30 minutes, and 1, 6, 12, 24 hours after surgery.
Results: The pain score in the placebo group is not significantly higher than in ketamine group postoperatively. While the pain scores in the two groups were very similar, throughout the 24 hours period, the incidence of nausea/emesis was also similarly low in both groups.
Conclusions: It was found that a fixed rate epidural infusions of ketamine (3-5 mg/h) are ineffective in controlling pain after surgery.
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KEYWORD
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Ketamine, Postoperative Pain
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