TY - JOUR
T1 - The addition of a small-dose ketamine infusion to tramadol for postoperative analgesia
T2 - A double-blinded, placebo-controlled, randomized trial after abdominal surgery
AU - Webb, Ashley R.
AU - Skinner, Bradley S.
AU - Leong, Samuel
AU - Kolawole, Helen
AU - Crofts, Tyron
AU - Taverner, Murray
AU - Burn, Sara J.
PY - 2007/4
Y1 - 2007/4
N2 - BACKGROUND: There are few data on combining ketamine with tramadol for postoperative analgesia in humans. We tested the hypothesis that adding ketamine to tramadol would improve analgesia after major abdominal surgery. METHOD: In this double-blind, randomized, controlled trial, adult patients (n = 120) having elective laparotomy were randomly assigned to a ketamine group (intraoperative ketamine 0.3 mg/kg and postoperative infusion at 0.1 mg·kg·h) or control group (equivalent volume/rate of normal saline). All patients received intraoperative tramadol 3 mg/kg and a tramadol infusion (0.2 mg·kg·h) for 48 h postoperatively and had morphine patient-controlled analgesia available for rescue analgesia. RESULTS: The ketamine group had less pain at rest (P = 0.01) and with movement (P = 0.02) and required less morphine (P = 0.003) throughout the 48-h study period. In the 0-24 h period, ketamine improved subjective analgesic efficacy (P = 0.008), was less sedating (P = 0.03), and required fewer physician interventions to manage severe pain (P = 0.01). Hallucinations were more common in ketamine patients, but other side effects were similar. CONCLUSION: Small-dose ketamine was a useful addition to tramadol and morphine after major abdominal surgery.
AB - BACKGROUND: There are few data on combining ketamine with tramadol for postoperative analgesia in humans. We tested the hypothesis that adding ketamine to tramadol would improve analgesia after major abdominal surgery. METHOD: In this double-blind, randomized, controlled trial, adult patients (n = 120) having elective laparotomy were randomly assigned to a ketamine group (intraoperative ketamine 0.3 mg/kg and postoperative infusion at 0.1 mg·kg·h) or control group (equivalent volume/rate of normal saline). All patients received intraoperative tramadol 3 mg/kg and a tramadol infusion (0.2 mg·kg·h) for 48 h postoperatively and had morphine patient-controlled analgesia available for rescue analgesia. RESULTS: The ketamine group had less pain at rest (P = 0.01) and with movement (P = 0.02) and required less morphine (P = 0.003) throughout the 48-h study period. In the 0-24 h period, ketamine improved subjective analgesic efficacy (P = 0.008), was less sedating (P = 0.03), and required fewer physician interventions to manage severe pain (P = 0.01). Hallucinations were more common in ketamine patients, but other side effects were similar. CONCLUSION: Small-dose ketamine was a useful addition to tramadol and morphine after major abdominal surgery.
UR - http://www.scopus.com/inward/record.url?scp=34047274267&partnerID=8YFLogxK
U2 - 10.1213/01.ane.0000256961.01813.da
DO - 10.1213/01.ane.0000256961.01813.da
M3 - Article
C2 - 17377106
AN - SCOPUS:34047274267
SN - 0003-2999
VL - 104
SP - 912
EP - 917
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
IS - 4
ER -