Open AccessThe Effect of Intraoperative Ketamine and Magnesium Sulfate on Acute Pain and Opioid Consumption After Spine Surgery
Author(s) -
Farhad Etezadi,
Mansour Farzizadeh,
Hamid Reza Sharifinia,
Maysam Alimohammadi,
Mohammad Reza Khajavi
Publication year - 2020
Publication title -
acta medica iranica.
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.218
H-Index - 27
eISSN - 1735-9694
pISSN - 0044-6025
DOI - 10.18502/acta.v58i5.3955
Subject(s) - medicine , ketamine , anesthesia , analgesic , placebo , morphine , randomized controlled trial , surgery , saline , alternative medicine , pathology
Ketamine and magnesium in brain act as an N-methyl-D-aspartate receptor antagonist that has been shown to be useful in the reduction of acute postoperative pain and analgesic consumption in a variety of surgical interventions. We hypothesized that combination of low dose ketamine and magnesium would reduce early postoperative opiate consumption and analgesic requirement after 6 weeks. This was a randomized, prospective, controlled-placebo trial involving elective and eligible patients undergoing lumbar spine surgery. Seventy patients in the treatment group were administered 0.5 mg/kg intravenous ketamine and 1 gram of magnesium as an intravenous bolus slowly during 3 minute before incision and 0.25 mg/kg/hr ketamine and 0,5 g/hr magnesium intravenous infusion during surgery. Seventy patients in the placebo group received saline of equivalent volume. Patients were observed for48 h postoperatively and followed up at 6 weeks. The primary outcome was 48h morphine consumption. The severity of pain was lower in the intervention group than in the placebo group during 48 hr post-operatively, morphine consumption in this group also decreased significantly during this period. Intraoperative ketamine-magnesium reduces opiate consumption in the 48-h postoperative period. This combination may also reduce pain intensity throughout the postoperative period in this patient population.