Abstract

REDONDO GOMEZ, Zhachel Alejandro. Ketamine as a co-adjuvant drug in perioperative pain control in major abdominal surgery. Rev cuba anestesiol reanim [online]. 2013, vol.12, n.3, pp. 210-221. ISSN 1726-6718.

Introduction: the combination of ketamine with morphine decreases both pain and the consumption of the latter drug during the postoperative period. However the optimal dose and duration of ketamine are yet to be determined. Objectives: to evaluate the effect of ketamine administration on postoperative morphine consumption, pain reduction, and adverse effects of ketamine in major abdominal surgery. Method: a prospective, randomized double-blind study was made in 75 patients scheduled for major abdominal surgery and divided into 3 groups: (1) PERI Group: received ketamine intraoperatively and postoperatively 48 hours after surgery (2 ug / kg / min after a bolus of 0.5 mg / kg); (2) INTRA Group: received only intraoperative ketamine (2 mg / kg / min after a bolus of 0.5 mg / kg), (3) CTRL Group: received placebo. Morphine consumption, visual analogical scale and the adverse effects in the first 48 years were evaluated. Results: cumulative morphine consumption 24 hours after the surgical anesthetic procedure was significantly lower in the PERI group (27 mg ± 17) than in the INTRA (48 mg ± 40.5) and CTRL (50 mg ± 22) (p <0.005). The visual analogical scale was significantly lower in PERI and INTRA groups than in CTRL (p<0.002). A higher nausea incidence was observed in the CTRL group compared to the PERI one (41 % vs. 8 %, (p = 0.005) ). Conclusions: low doses of ketamine improve postoperative analgesia with a reduction in morphine consumption when it is administrated for 48 years in the postoperative phase with low adverse effects incidence.

Keywords : ketamine; postoperative; morphine consumption; major abdominal surgery.

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