Continues Postoperative Analgesia: A Double-Blinded, Placebo-Controlled, Randomized Clinical Trial the Addition of a Small-Dose Ketamine Infusion to Tramadol Infusion

Haki Ismael, Ahmed; Hadi Muslih, Ali

	Continues Postoperative Analgesia: A Double-Blinded, Placebo-Controlled, Randomized Clinical Trial the Addition of a Small-Dose Ketamine Infusion to Tramadol Infusion
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 24, Issue 2, 2011, Pages 183-188
Authors
Ahmed Haki Ismael; Ali Hadi Muslih
Abstract
Background: There are few data on combining ketamine with tramadol for continuous postoperative analgesia in humans. The hypothesis of adding ketamine to tramadol would improve analgesia after major and super-major surgery had been tested. Method: In this double-blind, randomized, controlled trial, adult patients (n = 120) having elective major surgery were randomly assigned to a ketamine group (postoperative infusion at 0.1 mg / kg / h) or control group (equivalent volume/rate of normal saline). All patients received intra-operative tramadol 3 mg/kg and a tramadol infusion (0.2 mg / kg /h) for 48 h postoperatively. Results: In the 0–24 h period, ketamine improved subjective analgesic efficacy (P < 0.05), was less sedating (P < 0.05), and required fewer physician interventions to manage severe pain (P < 0.05). The ketamine group had less pain at rest (P < 0.05) and with movement (P < 0.05) and required less additional analgesic (Diclofenac sodium) (P < 0.05) throughout the 48-h study period. Hallucinations were more common in ketamine patients, but other side effects were similar. Conclusion: Small-dose ketamine was a useful addition to tramadol infusion after major and super-major surgery in continuous postoperative analgesia. Key words: Ketamine infusion, Tramadol infusion, Postoperative continuous analgesia, Subjective analgesia efficacy (SAE)
Keywords
Ketamine infusion; Tramadol infusion; Postoperative continuous analgesia; Subjective analgesia efficacy

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