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Lack of pre‐emptive analgesic effect of (R)‐ketamine in laparoscopic cholecystectomy
Author(s) -
Mathisen L. C.,
Aasbø V.,
Ræder J.
Publication year - 1999
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.1999.430218.x
Subject(s) - medicine , ketamine , anesthesia , analgesic , visual analogue scale , saline , placebo , cholecystectomy , surgery , laparoscopic cholecystectomy , alternative medicine , pathology
Aim: This study evaluated the pre‐emptive analgesic effect of intravenous (i.v.) (R)‐ketamine in laparoscopic cholecystectomy. (R)‐ketamine was used due to the lower incidence of side‐effects. Methods: Sixty patients who underwent surgery under general anesthesia were randomly allocated to 3 groups and studied in a double‐blind manner. Two i.v. injections were administered: one after induction of anesthesia, approximately 3 min before surgery, and one after surgery. The placebo group (PLA, n=20) received saline in both injections. The preoperative group (PRE, n=20) received (R)‐ketamine 1 mg/kg and then saline. The postoperative group (POST, n=20) received saline and then (R)‐ketamine 1 mg/kg. Postoperatively, the patients used a patient‐controlled analgesia (PCA) pump. Pain was evaluated with a visual analog scale (VAS) at 30 min and every hour for 4 h and with a verbal rating scale (VRS) at 24 h and after 7 days. Results: There were no occurence of side‐effects from (R)‐ketamine. VAS and VRS at 1, 2, 3, and 4 h postoperatively showed no statistical differences. In the POST group, extubation was delayed and pain score (VAS) at 30 min postoperatively was significantly lower ( P <0.05) than the two other groups. There were no statistical differences in meperidine consumption during the first 4 h postoperatively and no differences in consumption of analgesics at 24 h and 7 days. Conclusion: In this study a 1 mg/kg dose of (R)‐ketamine given at the end of surgery exerted a short‐lasting hypnotic and analgesic effect. The same dose given preoperatively did not show postoperative analgesic effect or pre‐emptive effect.