Pre-emptive Analgesia: The Effect of Low-Dose Ketamine on the Postoperative Pain after Circumcision with Unilateral Hydrocelectomy in Children.
10.4097/kjae.1998.35.2.334
- Author:
Il Ok LEE
1
Author Information
1. Departments of Anesthesiology, Korea University Medical School.
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Anesthetics, intravenous: ketamine;
Pain, postoperative: pre-emptive analgesia;
Surgery, urologic: circumcision
- MeSH:
Analgesia*;
Analgesics;
Anesthesia;
Body Weight;
Child*;
Circumcision, Male*;
Ethics Committees;
Female;
Glutamic Acid;
Humans;
Ketamine*;
Male;
N-Methylaspartate;
Neurons;
Pain, Postoperative*;
Parents
- From:Korean Journal of Anesthesiology
1998;35(2):334-340
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Backgrounds: Brief noxious stimuli are found to produce long-lasting neuronal sensitization. This cumulative depolarization results from the activation by glutamate of N-methyl-D-aspartic acid (NMDA) receptor. Ketamine at subanesthetic doses blocks the channel associated with the NMDA receptor. The aim of this study was to investigate the pre-emptive effect of ketamine in children after circumcision with unilateral hydrocelectomy. MATERIALS AND METHODS: We have compared the effect of preoperative ketamine (0.3 mg/kg) in a double-blind, randomized study, which was approved by the local Ethics Committee. Informed consents were obtained from their parents. After induction of anesthesia, patients were allocated randomly to receive a ketamine (n=20) or placebo (n=20) intravenously before surgery. Postoperative pain was rated on a faces scale for the first 24 hours. If pain occurred, children received tiaprofenic acid in a dose related to body weight. The cumulative pain score, the time of the first requirement of analgesics, and total requirement of analgesics for 24 hours were also checked. RESULTS: The pain scores at 4, 5, 6, 7, 8, 9, and 12 hours after operation were significantly low in ketamine group. The cumulative pain scores for the first 8 hours and the total requirements of analgesics were significantly low in ketamine group. The time of the first requirement of analgesic was significantly delayed in ketamine group. CONCLUSIONS: Preoperative ketamine in the pediatric circumcision with unilateral hydrocelectomy is effective on the reducing the intensity of the postoperative pain. The results of this study support the theory of pre-emptive analgesia of ketamine.
