Comparison between Continuously Intravenous Low Dose and Intermittently Intramuscular Administration of Ketamine to Reduce Postoperative Pain in Onco-gynecologic Patients
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Abstract
Introduction: Ketamine, known as general anesthetic
drug and short acting analgesic drug during operation,
helps to reduce the requirement of postoperative morphine
and its side effects.
Objective: to compare postoperative analgesia of low
dose ketamine administered by intermittently intramuscular
and continuously intravenous during anesthesia in
onco-gynecologic setting.
Materials and methods: Forty patients undergoing
onco-gynecologic surgery were randomized into
intravenous (IV) and intramuscular (IM) groups. During
induction of anesthesia, all patients received ketamine 0.5
mg/kg intravenously. Then, ketamine 0.25 mg/kg/hr
continuously to IV groups and 1 mg/kg were administered
intermittently intramuscular every 1 hour to IM groups.
In the recovery room, participants manipulate their pain
with morphine via PCA pump. Time to first morphine
requirement, morphine accumulation in 24 hours and its
side effects were recorded.
Results: Time to first morphine requirement is not different
between groups although there is a trend longer for the
intramuscular group (87.0±122.9 min vs 37.0±56.6 min,
p = 0.173). Morphine accumulation in 24 hours and its side
effects were also not different.
Conclusion: Low dose ketamine administered by
intermittently intramuscular during anesthesia provided
postoperative analgesia equally to continuously
intravenous in onco-gynecologic setting.
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