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Anesth Analg 2007;104:912-917
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000256961.01813.da

ANALGESIA

The Addition of a Small-Dose Ketamine Infusion to Tramadol for Postoperative Analgesia: A Double-Blinded, Placebo-Controlled, Randomized Trial After Abdominal Surgery

Ashley R. Webb, MBBS, FANZCA, Bradley S. Skinner, MBBS, Samuel Leong, MBBS, FANZCA, Helen Kolawole, MBBS, FANZCA, Tyron Crofts, MBBS, FANZCA, Murray Taverner, MBBS, FANZCA, and Sara J. Burn, BA RN

From the Department of Anesthesia, Frankston Hospital, Frankston, Victoria, Australia.

Address correspondence and reprint requests to Ashley R. Webb, MBBS, FANZCA, Department of Anesthesia, Frankston Hospital, Frankston, Victoria, Australia. Address e-mail to awebb{at}phcn.vic.gov.au.

Abstract

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–1 · h–1) 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–1 · h–1) 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.




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J. Zakine, D. Samarcq, E. Lorne, M. Moubarak, P. Montravers, S. Beloucif, and H. Dupont
Postoperative Ketamine Administration Decreases Morphine Consumption in Major Abdominal Surgery: A Prospective, Randomized, Double-Blind, Controlled Study
Anesth. Analg., June 1, 2008; 106(6): 1856 - 1861.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.