Beneficial Effects of Adding Ketamine to Intravenous Patient-Controlled Analgesia with Fentanyl after the Nuss Procedure in Pediatric Patients.
10.3349/ymj.2012.53.2.427
- Author:
Moon Ho CHA
1
;
Ji Hye EOM
;
Yoon Sook LEE
;
Woon Young KIM
;
Young Cheol PARK
;
Sam Hong MIN
;
Jae Hwan KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Korea. anejhkim@korea.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Fentanyl;
funnel chest;
ketamine;
patient-controlled analgesia;
pediatrics
- MeSH:
Analgesia, Patient-Controlled/*methods;
Analgesics/*therapeutic use;
Child;
Double-Blind Method;
Female;
Fentanyl/*therapeutic use;
Funnel Chest/surgery;
Humans;
Injections, Intravenous;
Ketamine/*therapeutic use;
Male;
Pain, Postoperative/drug therapy
- From:Yonsei Medical Journal
2012;53(2):427-432
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this prospective, double-blind, randomized study was to investigate the analgesic effects of low-dose ketamine on intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control in pediatric patients following the Nuss procedure for pectus excavatum. MATERIALS AND METHODS: Sixty pediatric patients undergoing the Nuss procedure were randomly assigned to receive fentanyl (Group F, n=30) or fentanyl plus ketamine (Group FK, n=30). Ten minutes before the end of surgery, following the loading dose of each solution, 0.5 microg/kg/hr of fentanyl or 0.5 microg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 mL/hr; bolus, 0.5 mL; lock out interval, 30 min). Fentanyl consumption, pain score, ketorolac use, nausea/vomiting, ondansetron use, pruritus, respiratory depression, hallucination, dreaming, and parent satisfaction with pain control were measured throughout the 48 hours following surgery. RESULTS: The pain scores, ketorolac use, and fentanyl consumption of Group FK were significantly lower than in Group F (p<0.05). The incidence of nausea/vomiting and ondansetron use in Group FK was significantly lower than in Group F (p<0.05). There were no reports of respiratory depression, hallucination or dreaming. Parent satisfaction with pain control was similar between the two groups. CONCLUSION: We concluded that low-dose ketamine added to IV-PCA with fentanyl after the Nuss procedure in pediatric patients can reduce pain scores, consumption of fentanyl, and incidence of nausea/vomiting without increasing side effects.
