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document
Preoperative small-dose ketamine has no preemptive analgesic effect in patients undergoing total mastectomy . UNLABELLED We evaluated the preemptive analgesic effect of a small dose of ketamine given before or immediately after surgery in a randomized , double-blinded study performed in 128 women undergoing total mastectomy . Group 1 patients received ketamine 0.15 mg/kg as a 5-mL i.v . injection 5 min before surgery and isotonic saline 5 mL i.v . at the time of skin closure . Group 2 received 5 mL i.v . of isotonic saline , then 0.15 mg/kg i.v . ketamine . A standard general anesthesia procedure including sufentanil was used . In the recovery room , patient-controlled analgesia i.v . morphine was used for postoperative analgesia . Postoperative pain was assessed by measuring morphine consumption and visual analog scale pain scores . No significant intergroup differences were seen in the pain scores . Patient-controlled analgesia morphine consumption was lower during the first 2 h after surgery in patients given ketamine at the time of skin closure . No patient complained of hallucinations or nightmares . The incidence of adverse effects was not different between the two groups . In conclusion , administering ketamine at the end of surgery is more effective in reducing morphine consumption than it is when given before surgery . IMPLICATIONS We administered the same small dose of ketamine before or after surgery . The preoperative administration of 0.15 mg/kg ketamine in patients undergoing total mastectomy did not elicit a preemptive analgesic effect . Ketamine given at closure reduced the patient-controlled analgesia morphine requirement in the first 2 h after surgery .
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Intervention_Pharmacological
ketamine
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Intervention_Pharmacological
ketamine
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Intervention_Pharmacological
ketamine 0.15 mg/kg as a 5-mL i.v .
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Intervention_Surgical
injection 5 min before surgery
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Intervention_Pharmacological
isotonic saline 5 mL i.v .
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Intervention_Pharmacological
5 mL i.v . of isotonic saline ,
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Intervention_Pharmacological
0.15 mg/kg i.v . ketamine
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Intervention_Pharmacological
ketamine
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Intervention_Pharmacological
ketamine
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Intervention_Pharmacological
ketamine
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Intervention_Pharmacological
ketamine
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Intervention_Pharmacological
Ketamine
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Outcome_Pain
morphine consumption and visual analog scale pain scores .
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Outcome_Mental
Patient-controlled analgesia
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Outcome_Adverse-effects
hallucinations
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Outcome_Adverse-effects
nightmares .
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Outcome_Adverse-effects
incidence of adverse effects
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Participant_Sample-size
128
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Participant_Sex
women
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Participant_Condition
undergoing total mastectomy
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Participant_Condition
undergoing total mastectomy