Does Intravenous Ketamine Enhance Analgesia after Arthroscopic Shoulder Surgery with Ultrasound Guided Single-Injection Interscalene Block?: A Randomized, Prospective, Double-Blind Trial.
10.3346/jkms.2014.29.7.1001
- Author:
Jae Hee WOO
1
;
Youn Jin KIM
;
Hee Jung BAIK
;
Jong In HAN
;
Rack Kyung CHUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. ankyj@ewha.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Ketamine;
Interscalene Nerve Block;
Shoulder Surgery;
Pain, Postoperative
- MeSH:
Adult;
Aged;
Analgesia, Patient-Controlled;
Analgesics/*administration & dosage;
Arthroscopy;
Brachial Plexus/ultrasonography;
Double-Blind Method;
Female;
Humans;
Injections, Intravenous;
Ketamine/*administration & dosage;
Male;
Middle Aged;
Nerve Block;
Pain Measurement;
Pain, Postoperative/*drug therapy;
Prospective Studies;
Shoulder/*surgery;
Time Factors
- From:Journal of Korean Medical Science
2014;29(7):1001-1006
- CountryRepublic of Korea
- Language:English
-
Abstract:
Ketamine has anti-inflammatory, analgesic and antihyperalgesic effect and prevents pain associated with wind-up. We investigated whether low doses of ketamine infusion during general anesthesia combined with single-shot interscalene nerve block (SSISB) would potentiate analgesic effect of SSISB. Forty adult patients scheduled for elective arthroscopic shoulder surgery were enrolled and randomized to either the control group or the ketamine group. All patients underwent SSISB and followed by general anesthesia. During an operation, intravenous ketamine was infused to the patients of ketamine group continuously. In control group, patients received normal saline in volumes equivalent to ketamine infusions. Pain score by numeric rating scale was similar between groups at 1, 6, 12, 24, 36, and 48 hr following surgery, which was maintained lower than 3 in both groups. The time to first analgesic request after admission on post-anesthesia care unit was also not significantly different between groups. Intraoperative low dose ketamine did not decrease acute postoperative pain after arthroscopic shoulder surgery with a preincisional ultrasound guided SSISB. The preventive analgesic effect of ketamine could be mitigated by SSISB, which remains one of the most effective methods of pain relief after arthroscopic shoulder surgery.
