Preoperative epidural ketamine does not have a postoperative opioid sparing effect

Anesthesia and Analgesia
N KucukM Tokdemir

Abstract

Ketamine reduces nociception by binding noncompetitively to the N-methyl-D-aspartate receptor, the activation of which provokes hypersensitivity within the central nervous system. We studied the analgesic effect of extradural ketamine given before or after upper abdominal surgery. We sought to assess the effect of ketamine on preemptive analgesia. Ketamine 60 mg was injected epidurally through an indwelling catheter that was inserted at the T7-8 or T8-9 interspace in 98 patients. Patients were randomly allocated into one of the two groups, each consisting of 49 patients: ketamine was given before the induction of anesthesia (Group 1) and after the parietal peritoneum was closed (Group 2). Sample size was calculated using a two-tailed alpha = 0.05 and power of 95%. For postoperative analgesia, meperidine 25 mg was given epidurally whenever a patient complained of pain or the visual analog scale score was greater than 4. The first and the second day cumulative meperidine consumption was not different between the two groups. We conclude that preoperative epidural ketamine 60 mg does not have a preemptive analgesic effect. In patients undergoing upper abdominal surgery, a single epidural injection of 60 mg of ketamine administered ...Continue Reading

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Citations

Jun 27, 2003·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Marc A BurmeisterThomas G Standl
Nov 24, 2004·International Journal of Oral and Maxillofacial Surgery·K S OngV C L Ho
Dec 18, 2007·Journal of Clinical Anesthesia·Kerem InanogluAlper Kararmaz
Feb 26, 2003·European Journal of Pain : EJP·Vincent L H HoffmannTheo F Meert
Sep 22, 2000·Current Review of Pain·D P Beltrutti Di Santo S
Sep 22, 2000·Current Review of Pain·O H Wilder-Smith
Oct 4, 2006·Current Opinion in Anaesthesiology·S A SchugH M Cardwell
May 27, 2003·Anesthesiology·Charles B BerdeSrinivasa N Raja
Feb 4, 2006·American Journal of Veterinary Research·Alonso G P GuedesElaine P Rudé

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