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Preemptive effect of IV S(+)-ketamine for hysterectomy

Abstract:

Background: Ketamine is a NMDA receptor blocker, which has been used to reduce central sensitisation. This study is aimed to evaluate the preemptive effect of IV S(+)-ketamine (0.5 mg/kg) for hysterectomy. Methods: Thirty patients aged 18-60 years, Physical State (ASA) I or II, were randomly distributed into two groups: G1 patients received IV 0.5 mg/kg of S(+)-ketamine 20 min (min) before surgical incision and saline 20 min after surgical incision. G2 received saline 20 min before surgical incision and IV S(+)-ketamine (0.5 mg/kg) after surgical incision. The patients had general anaesthesia. In the postoperative period, analgesia was maintained with epidural fentanyl. Pain was assessed by numerical scale at T0 (arousal), and T6, T12, T18, T24 later. The time interval for the first request of additional analgesia and the total amount of analgesic consumption were reported. Results: There was a statistical difference between the groups in the median values of pain intensity in T0 on the numerical scale (G1 = 3.00; G2 = 9.00). The time interval to require the first analgesic supplement was longer in the G1 than G2 (45.33 min versus 9.66 min; p = 0.04; Mann-Whitney's test). There was a statistical difference between G1 and G2 in the total dose of epidural fentanyl required for supplementation (G1: 103 μg; G2: 203 μg; p < 0.0001; Mann-Whitney's test). Conclusion: In this study, pre-incisional S(+)-ketamine (0.5 mg/kg) had a preemptive effect in hysterectomy. © 2005 Elsevier B.V. All rights reserved.