Abstract

CADAVID PUENTES, Adriana; RODELO, Karoll A; MEDINA, Diana P  and  SANCHEZ, Ana M. Efecto de adicionar ketamina a la morfina en analgesia controlada por el paciente (pca) en un modelo de laparotomía. Ensayo clínico aleatorizado doble ciego controlado . Rev. colomb. anestesiol. [online]. 2008, vol.36, n.1, pp.19-24. ISSN 0120-3347.

Objective : Given the analgesic potential and opioid sparing effect of ketamine, we compared the effect of additioning ketamine to morphine on IV PCA (patient controlled analgesia) in a laparotomy model. We evaluated pain level, opioid consumption and frequent adverse effects of morphine in both groups. Pattients and methods: Randomized controlled trial in patients scheduled for elective laparotomy. One hundred and twelve patients (112) ASA I, II or III aged 18 to 85 years old were randomly assigned to receive morphine 1mg/ml (group 1, n=53) or morphine 1 mg/ml plus ketamine 1mg/ml (group 2 n=59). We assessed cumulative doses of morphine for each group at 12, 24,36 and 48 hours after installation of intravenous PCA, pain level at rest and movement, hemodynamic (arterial pressure) and opioid related effects: nausea and vomiting, sedation and pruritus between groups. Results: Pain intensity level was similar in both groups. In group 2 (morphine plus ketamine) there was a 17% less in opioid consumption, however, this difference did not reach statistical significance. Considering adverse effects derivate from opioids, there was not a significant difference between groups. Conclusion: Ketamine initiated with IV PCA for postoperative pain control after laparotomy does not reduce significantly morphine consumption or adverse effects related to opioid effect .

Keywords : Patient controlled analgesia; postoperative pain; ketamine.

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