Perioperative small-dose S(+)-ketamine has no incremental beneficial effects on postoperative pain when standard-practice opioid infusions are used

Anesthesia and Analgesia
Wolfgang JakschSylvia Fitzal

Abstract

Several studies report that when small-dose racemic ketamine, an N-methyl-D-aspartate receptor antagonist, is administered perioperatively, opioid consumption is reduced postoperatively. S(+)-ketamine has a higher affinity for the N-methyl-D-aspartate receptor and less-serious side effects than racemic ketamine. Thirty patients scheduled for elective arthroscopic anterior cruciate ligament repair were enrolled in this randomized, double-blinded clinical trial designed to determine the preemptive effect of S(+)-ketamine on postoperative analgesia requirements in a setting of clinically relevant perioperative analgesia. Total IV anesthesia was induced and maintained with remifentanil (0.125-1.0 microg x kg(-1) x min(-1)) and a propofol target-controlled infusion (target 2-4 microg/mL). The Ketamine group received a bolus of 0.5 mg/kg S(+)-ketamine before incision, followed by a continuing infusion of 2 microg x kg(-1) x min(-1) until 2 h after emergence from anesthesia. The Control group received NaCl in the same sequence. After IV morphine provided pain relief down to < or =3 on a visual analog scale scored from 0 to 10, patients were connected to a patient-controlled analgesia device. There were no significant differences betwe...Continue Reading

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Citations

Jul 24, 2004·Anesthesia and Analgesia·Kathirvel SubramaniamRichard A Steinbrook
Dec 25, 2004·Anesthesiology·Sabine Himmelseher, Marcel E Durieux
Aug 19, 2006·Critical Care Medicine·John M Taylor, Michael A Gropper
Jul 3, 2015·The Cochrane Database of Systematic Reviews·Rae F BellEija A Kalso
Mar 8, 2016·Anesthesiology Research and Practice·Luiz Eduardo de Paula Gomes MiziaraAnderson Garcia Lima E Paula
Oct 27, 2004·Anesthesia and Analgesia·Pasi LahtinenMarkku Hynynen
Jul 24, 2010·Korean journal of anesthesiology·Sun Young ParkSoon Im Kim
Oct 6, 2006·Current Opinion in Anaesthesiology·Frédérique S Servin
Dec 6, 2005·European Journal of Pain : EJP·Christophe AvelineFrancis Bonnet
Jul 21, 2011·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Kevin LaskowskiHyun J Lim
Apr 9, 2013·Pain Practice : the Official Journal of World Institute of Pain·Reza Shariat MoharariFarhad Etezadi
Dec 23, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Julie Jouguelet-LacosteJacques E Chelly
Jun 16, 2004·Acta Anaesthesiologica Scandinavica·A C Van ElstraeteB Polin
Apr 24, 2004·Anesthesia and Analgesia·Helena ArgiriadouEberhard Kochs
Jan 26, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Thierry LebrunLuc Pierre-Louis
Oct 5, 2006·Current Opinion in Anaesthesiology·Joel Katz, Colin J L McCartney
Sep 6, 2012·Korean journal of anesthesiology·Hanan F KhafagyYasser M Samhan
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Jan 24, 2007·Veterinary Anaesthesia and Analgesia·Peter J PascoeCynthia Kollias-Baker

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