Анестезия и клинические исследования
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ISSN: 2155-6148
ISSN: 2155-6148
Abdullah Al-Murad*
Background: Postoperative pain management is a challenging aspect of patient care. To enhance traditional analgesics for postoperative pain, ketamine has been utilized as an adjuvant. However, the most appropriate dosage of ketamine has yet to be determined. This study sought to investigate the effects of administering a high dose of ketamine during surgery on postoperative pain experienced by patients undergoing lumbar surgery.
Methods: A prospective study involving 800 patients undergoing lumbar surgery was conducted. Patients were randomly allocated into two groups: the ketamine group (n=400) received an intravenous dose of 1 mg/kg of ketamine after anesthesia inductions, followed by a continuous infusion of 0.20 mg/kg/hour throughout surgery, while the control group (n=400) received normal saline. Pain intensity was assessed using the Numeric Rating Scale (NRS) at 2, 6, 12, and 24 hours post-surgery. The primary outcome was the NRS score at 24 hours after surgery, while the secondary outcomes were the NRS scores at 2, 6, and 12 hours after surgery, the incidence of Postoperative Nausea and Vomiting (PONV), and the need for rescue analgesia.
Results: The mean NRS score at 24 hours post-surgery was significantly lower in the ketamine group compared to the control group (4.8 ± 1.2 vs. 6.2 ± 1.4, P<0.001). Additionally, the NRS scores at 2, 6, and 12 hours after surgery were significantly lower in the ketamine group compared to the control group (P<0.001). The incidence of PONV was comparable between the two groups (P= 0.136), and the need for rescue analgesia was significantly lower in the ketamine group compared to the control group (P<0.001).
Conclusion: Administration of high-dose ketamine during surgery is effective in reducing postoperative pain experienced by patients undergoing lumbar surgery. Thus, ketamine could serve as an adjuvant to traditional analgesics for postoperative pain management.