JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (53) Citing Articles via Google Scholar Google Scholar Articles by Reeves, M. Articles by Hunt, J. O. Search for Related Content PubMed PubMed Citation Articles by Reeves, M. Articles by Hunt, J. O.

---

ANESTHETIC PHARMACOLOGY

Adding Ketamine to Morphine for Patient-Controlled Analgesia After Major Abdominal Surgery: A Double-Blinded, Randomized Controlled Trial

Department of Anaesthesia & Pain Management, Alfred Hospital; Departments of Anaesthesia, and Epidemiology & Preventive Medicine, Monash University, Australia

Address correspondence and reprint requests to David Lindholm, MB BS, Department of Anaesthesia & Pain Management, The Alfred Commercial Road, Prahran, Victoria, 3181 Australia. Address e-mail to D.Lindholm{at}alfred.org.au

In this double-blinded, randomized controlled trial we tested if the addition of ketamine to morphine for patient-controlled analgesia (PCA) resulted in improved analgesic efficacy and lower pain scores compared with morphine PCA alone after major abdominal surgery. Seventy-one patients were ran-domly allocated to receive either morphine 1 mg/mL (Group M) or morphine 1 mg/mL plus ketamine 1 mg/mL (Group MK) delivered via PCA after surgery. No other analgesics or regional blocks were permitted during the 48-h study period. Postoperatively there were no differences between the groups for subjective assessment of analgesic efficacy, pain scores at rest, and on movement, opioid consumption, or adverse events. Group MK patients performed worse in cognitive testing (P = 0.037). There was an increased risk of vivid dreaming in patients who received ketamine (relative risk = 1.8, 95% confidence interval 0.78–4.3). We conclude that small-dose ketamine combined with PCA morphine provides no benefit to patients undergoing major abdominal surgery.

Implications: We performed a randomized, controlled trial comparing the use of ketamine andmorphine with morphine alone to relieve pain after major abdominal surgery.Ketamine did not improve pain relief and merely increased sideeffects.

This article has been cited by other articles:

				M. Yamauchi, M. Asano, M. Watanabe, S. Iwasaki, S. Furuse, and A. Namiki Continuous Low-Dose Ketamine Improves the Analgesic Effects of Fentanyl Patient-Controlled Analgesia After Cervical Spine Surgery Anesth. Analg., September 1, 2008; 107(3): 1041 - 1044. [Abstract] [Full Text] [PDF]

				G. Sveticic, F. Farzanegan, P. Zmoos, S. Zmoos, U. Eichenberger, and M. Curatolo Is the Combination of Morphine with Ketamine Better than Morphine Alone for Postoperative Intravenous Patient-Controlled Analgesia? Anesth. Analg., January 1, 2008; 106(1): 287 - 293. [Abstract] [Full Text] [PDF]

				P. Michelet, C. Guervilly, A. Helaine, J. P. Avaro, D. Blayac, F. Gaillat, T. Dantin, P. Thomas, and F. Kerbaul Adding ketamine to morphine for patient-controlled analgesia after thoracic surgery: influence on morphine consumption, respiratory function, and nocturnal desaturation Br. J. Anaesth., September 1, 2007; 99(3): 396 - 403. [Abstract] [Full Text] [PDF]

				A. R. Webb, B. S. Skinner, S. Leong, H. Kolawole, T. Crofts, M. Taverner, and S. J. Burn The Addition of a Small-Dose Ketamine Infusion to Tramadol for Postoperative Analgesia: A Double-Blinded, Placebo-Controlled, Randomized Trial After Abdominal Surgery Anesth. Analg., April 1, 2007; 104(4): 912 - 917. [Abstract] [Full Text] [PDF]

				T. Lebrun, A. C. Van Elstraete, I. Sandefo, B. Polin, and L. Pierre-Louis Lack of a pre-emptive effect of low-dose ketamine on postoperative pain following oral surgery: [Absence d'effet preventif de faibles doses de ketamine sur la douleur postoperatoire en chirurgie buccale] Can J Anesth, February 1, 2006; 53(2): 146 - 152. [Abstract] [Full Text] [PDF]

				P. F. White The Changing Role of Non-Opioid Analgesic Techniques in the Management of Postoperative Pain Anesth. Analg., November 1, 2005; 101(5S_Suppl): S5 - 22. [Abstract] [Full Text] [PDF]

				J. R. Sneyd Recent advances in intravenous anaesthesia Br. J. Anaesth., November 1, 2004; 93(5): 725 - 736. [Abstract] [Full Text] [PDF]

				K. Subramaniam, B. Subramaniam, and R. A. Steinbrook Ketamine as Adjuvant Analgesic to Opioids: A Quantitative and Qualitative Systematic Review Anesth. Analg., August 1, 2004; 99(2): 482 - 495. [Abstract] [Full Text] [PDF]

				H. Schulte, A. Sollevi, and M. Segerdahl The Synergistic Effect of Combined Treatment with Systemic Ketamine and Morphine on Experimentally Induced Windup-Like Pain in Humans Anesth. Analg., June 1, 2004; 98(6): 1574 - 1580. [Abstract] [Full Text] [PDF]

				C. J. L. McCartney, A. Sinha, and J. Katz A Qualitative Systematic Review of the Role of N-Methyl-D-Aspartate Receptor Antagonists in Preventive Analgesia Anesth. Analg., May 1, 2004; 98(5): 1385 - 1400. [Abstract] [Full Text] [PDF]

				N. Guillou, M. Tanguy, P. Seguin, B. Branger, J.-P. Campion, and Y. Malledant The Effects of Small-Dose Ketamine on Morphine Consumption in Surgical Intensive Care Unit Patients After Major Abdominal Surgery Anesth. Analg., September 1, 2003; 97(3): 843 - 847. [Abstract] [Full Text] [PDF]

				H. Unlugenc, M. Ozalevli, Y. Gunes, T. Guler, and G. Isik Pre-emptive analgesic efficacy of tramadol compared with morphine after major abdominal surgery Br. J. Anaesth., August 1, 2003; 91(2): 209 - 213. [Abstract] [Full Text] [PDF]

				M. Luginbuhl, A. Gerber, T. W. Schnider, S. Petersen-Felix, L. Arendt-Nielsen, and M. Curatolo Modulation of Remifentanil-Induced Analgesia, Hyperalgesia, and Tolerance by Small-Dose Ketamine in Humans Anesth. Analg., March 1, 2003; 96(3): 726 - 732. [Abstract] [Full Text] [PDF]

				A. A. Weinbroum A Single Small Dose of Postoperative Ketamine Provides Rapid and Sustained Improvement in Morphine Analgesia in the Presence of Morphine-Resistant Pain Anesth. Analg., March 1, 2003; 96(3): 789 - 795. [Abstract] [Full Text] [PDF]

				J.-P. Laulin, P. Maurette, J.-B. Corcuff, C. Rivat, M. Chauvin, and G. Simonnet The Role of Ketamine in Preventing Fentanyl-Induced Hyperalgesia and Subsequent Acute Morphine Tolerance Anesth. Analg., May 1, 2002; 94(5): 1263 - 1269. [Abstract] [Full Text] [PDF]

				R. Schmid, G. Koren, J. Klein, and J. Katz The Stability of a Ketamine-Morphine Solution Anesth. Analg., April 1, 2002; 94(4): 898 - 900. [Abstract] [Full Text] [PDF]

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