The Effect of Low Dose i.v. Ketamine in Combination with Epidural Morphine on Postoperative Pain.
10.4097/kjae.2005.49.1.81
- Author:
Hyun Do LEE
1
;
Hyung Kyun KIM
;
Su Nam LEE
;
So Young LEE
;
Ji Heui LEE
;
Dong Ho PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. sunamlee@netian.com
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
ketamine;
morphine;
postoperative pain
- MeSH:
Analgesia, Epidural;
Anesthesia;
Bupivacaine;
Cough;
Enflurane;
Gastrectomy;
Humans;
Ketamine*;
Midazolam;
Morphine*;
Pain, Postoperative*;
Skin;
Thiopental;
Vecuronium Bromide
- From:Korean Journal of Anesthesiology
2005;49(1):81-85
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The purpose of this study was to evaluate the effect of low dose i.v. ketamine in combination with epidural morphine on postoperative pain after gastrectomy. METHODS: 40 patients scheduled for elective gastrectomy were investigated in a randomized study. All patients received epidural morphine (0.05 mg/kg) and bupivacaine (0.25%) as a bolus dose of 10 ml 40 min prior to skin incision. In addition, patient- controlled epidural analgesia (PCEA) with epidural bupivacaine (0.125%) and morphine (0.1 mg/ml) (bolus dose 1 ml, continuous infusion 1 ml/h, lock out interval 15 min) was offered from the time after 10 ml bolus dose. In the ketamine group, ketamine 0.5 mg/kg was administered 10 min prior to skin incision and then maintained continuously until skin closure at a dosage of 10microgram/kg/min. In the second group anesthesia was induced with thiopental sodium 4 mg/kg, midazolam 0.5 mg/kg, vecuronium 0.1 mg/kg and maintained with 66% N2O-O2, 1-3 vol% enflurane. The intensities of spontaneous pain and of coughing associated pain were measured using a visual analogue scale. Cumulative morphine consumption was measured at 2, 6, 12, 24, 48 h after surgery. Side effects were evaluated at 48 h after surgery. RESULTS: VAS and cumulative morphine consumption at 2, 6, 12, 24, 48 h postoperatively showed no statistical differences between the two groups, and no statistical differences in side effects were observed at 48h after surgery. CONCLUSIONS: We were unable to demonstrate any additional analgesic effect of low dose i.v. ketamine in combination with epidural morphine and bupivacaine.
