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Anesth Analg 1999;89:98
© 1999 International Anesthesia Research Society

AMBULATORY ANESTHESIA

Small-Dose Ketamine Enhances Morphine-Induced Analgesia After Outpatient Surgery

Manzo Suzuki, MD, Kentaro Tsueda, MD, Peter S. Lansing, MD, Merritt M. Tolan, MD, Thomas M. Fuhrman, MD, Connie I. Ignacio, MD, and Rachel A. Sheppard, BS

Department of Anesthesiology, University of Louisville School of Medicine, Louisville, Kentucky

Address correspondence and reprint requests to Manzo Suzuki, MD, Department of Anesthesiology, University of Louisville, KY 40292. Address e-mail to rashep01{at}gwise.louisville.edu

Small-dose ketamine may enhance the analgesic effect of opiates. We studied the effect of IV coadministration of small-dose ketamine 50–100 µg/kg with morphine 50 µg/kg on postoperative morphine requirements and pain in 140 patients undergoing outpatient surgery. Midazolam 1–2 mg was administered in the holding area. Anesthesia was induced with propofol 2–2.5 mg/kg and was maintained with desflurane in a nitrous oxide/oxygen mixture. Patients received morphine 50 µg/kg with placebo (Group 1, n = 35) or ketamine 50 µg/kg IV (Group 2, n = 35), 75 µg/kg IV (Group 3, n = 35), or 100 µg/kg IV (Group 4, n = 35) 15 min before the end of the operation. Pain and drowsiness were assessed using visual analog scales on arrival in the recovery room, then every 15 min until the time of discharge to phase 2 recovery (phase 1 recovery). Morphine consumption in Groups 3 and 4 was approximately 40% less than that in the control group (91 ± 9 and 89 ± 8 µg/kg vs 145 ± 9 µg/kg; P < 0.05 for both). Pain scores in Groups 3 and 4 were approximately 35% less than those in the control group at all time periods (P < 0.0001 for all). There was no significant group difference in drowsiness scores. Small-dose ketamine 75–100 µg/kg IV, enhanced morphine-induced analgesia after outpatient surgery. Simultaneous use of small doses of ketamine with morphine enhances the pain relief produced by morphine.

Implications: Simultaneous use of small doses of ketamine with morphine enhances the pain relief produced by morphine.




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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 © 1999 by the International Anesthesia Research Society.