Low-dose S+ ketamine in target-controlled intravenous anaesthesia with remifentanil and propofol for open gynaecological surgery: A randomised controlled trial

Indian Journal of Anaesthesia
Farida Binte IthninBan Leong Sng

Abstract

Using remifentanil-propofol target-controlled infusion (TCI) in open gynaecological surgeries could be associated with opioid-induced hyperalgesia postoperatively. This study's aim was to investigate the effect of low-dose S-ketamine compared with control on cumulative morphine consumption 24 h postoperatively in women undergoing open abdominal hysterectomy with remifentanil-propofol TCI technique. Ninety female patients above 21 years old who underwent elective open abdominal hysterectomy under general anaesthesia with remifentanil-propofol TCI were recruited. They were randomised to receive either normal saline as control (n = 44) or 0.25 mg/kg intravenous boluses of S-ketamine before skin incision and after complete removal of uterus (n = 45). The primary outcome measure was cumulative morphine consumption measured over 24 h postoperatively. The secondary outcome measures were incidences of opioid-related and psychotomimetic side effects, pain and level of sedation scores. The cumulative 24-h morphine consumption postoperatively (P = 0.0547) did not differ between both the groups. S-ketamine group had slower emergence from general anaesthesia (P = 0.0308) and lower pain scores (P = 0.0359) 15 min postoperatively. Sedation le...Continue Reading

Methods Mentioned

BETA
hysterectomies
hysterectomy
hormone replacement therapies
PCA
sedation
coronary artery bypass

Clinical Trials Mentioned

NCT03231683

Software Mentioned

SAS

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