Adding ketamine in a multimodal patient-controlled epidural regimen reduces postoperative pain and analgesic consumption

Yuan Yi Chia, Kang Liu, Yuan Chin Liu, Huang Chou Chang, Chih Shung Wong

研究成果: Article同行評審

114 引文 斯高帕斯(Scopus)

摘要

We designed this double-blind study to evaluate the effect of adding small-dose ketamine in a multimodal regimen of postoperative patient- controlled epidural analgesia (PCEA). Ninety-one patients, ASA physical status I-III, undergoing major surgery, received a standardized general anesthesia and epidural catheterization in an appropriate intervertebral space after surgery. A PCEA device was programmed to deliver a regimen of morphine 0.02 mg/mL, bupivacaine 0.8 mg/mL, and epinephrine 4 μg/mL, with the addition of ketamine 0.4 mg/mL (ketamine, n = 45) or without (control, n = 46). The mean visual analog pain scale (VAS) scores during cough or movement for the first 3 days after surgery were higher in the control group than in the ketamine group (P < 0.05), whereas the mean VAS score at rest for the first 2 days were higher in the control group than in the ketamine group (P < 0.05). Furthermore, patients in the control group consumed more multimodal analgesics than patients in the ketamine group for the first 2 days (P < 0.05). The sedation scores and the incidence of side effects (pruritus, nausea, emesis, sleep deprivation, motor block, and respiration depression) were similar between the two groups. We conclude that adding ketamine 0.4 mg/mL in a multimodal PCEA regimen provides better postoperative pain relief and decreases consumption of analgesics. Implications: Many studies have evaluated one or a combination of two analgesics for postoperative pain control, but few have examined a multimodal approach using three or four different epidural analgesics. This study demonstrates an additive analgesic effect when ketamine is added to a multimodal analgesic treatment.

原文English
頁(從 - 到)1245-1249
頁數5
期刊Anesthesia and analgesia
86
發行號6
DOIs
出版狀態Published - 1998 一月 1

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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