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Effect of low dose ketamine on perioperative analgesia in patients undergoing open abdominal hysterectomy - A double-blind, randomized, placebo-controlled trial

Lookup NU author(s): Melvin JoyORCiD

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Abstract

Background: Low‑dose ketamine can provide effective perioperative analgesia while reducing its side effects. This study aims to estimate the effect of a low dose of ketamine administered preemptively and during the surgery on postoperative opioid requirement and the incidence of side effects of ketamine. Methods: This prospective, double‑blind, randomized control trial enrolled 60 adult women (>18 years) scheduled for open abdominal hysterectomy. All patients received general anesthesia using a standard protocol. Patients were randomized to receive 0.2 mg/kg of ketamine as bolus before induction of anesthesia, followed by an infusion of 0.002 mg/kg/min for the duration of surgery (Group K) or an equivalent volume of 0.9% saline (Group C). The primary outcome was to compare the morphine requirement over the 24 h postoperatively between the two groups. The secondary outcomes were to compare the intraoperative morphine requirement, and the incidence of side effects of ketamine. Results: The intraoperative morphine requirement was significantly less (P = 0.006) in those who received ketamine (6.5 ± 1.5 mg) compared to the placebo (7.67 ± 1.7 mg). The 24‑hour morphine requirement was less in the Group K (7.87 ± 4.7 mg) compared to Group C (9.2 ± 4.5 mg), but was not statistically significant. The incidence of hallucination and nystagmus was significantly higher in the ketamine group, but it lasted <2 h. Conclusion: The preemptive and the intraoperative infusion of low‑dose ketamine decreases the morphine requirement intraoperatively but not during the postoperative period.

Publication metadata

Author(s): Mariappan R, Cherian VT, Joy M, Selvaraj KG

Publication type: Article

Publication status: Published

Journal: The Indian Anaesthetists’ Forum

Year: 2021

Volume: 22

Issue: 1

Pages: 67-72

Print publication date: 01/01/2021

Online publication date: 22/02/2021

Acceptance date: 04/08/2020

Date deposited: 23/08/2024

ISSN (print): 2589-7934

ISSN (electronic): 0973-0311

Publisher: Wolters Kluwer - Medknow

URL: https://doi.org/10.4103/TheIAForum.TheIAForum_80_20

DOI: 10.4103/TheIAForum.TheIAForum_80_20

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