Comparison of a preincisional and postincisional small does of ketamine for postoperative analgesia in children

Background. The aim of this randomized, double blind, placebo controlled prospective study was to investigate the preventive action of N-methyl-D-aspartate (NMDA) receptor antagonist ketamine on postoperative analgesia by comparing its administration preincisionally, at the end of operation and placebo in the management of postoperative pain in children. Methods: 90 children ASA I or II, scheduled for hernia repairs, circumcisions and orchydopexy, aged 4.5-14 years were randomly assigned in three groups: first :received low dose ketamine 0.3 mg/kg intravenously before the start of operation, second the same dose at the end of operation and the third group got placebo saline i.v. before the incision. The intensity of postoperative pain was measured by visual-analogue scale (VAS) at 2, 6, 12 and 24 h postoperatively. The rescue analgesic consumption, the time of the first request of postoperative analgesia and side effects were noted. Results: There were not any significant differences in VAS, the time of the first request of analgesia and analgesics' consumption in postoperative period between the preincisional and postincisional ketamine and placebo group. The side effects as sleep disturbances, hallucinations, and nightmares were equal in both ketamine groups. Conclusions: No significant difference was found between analgesic effects of preincisional ketamine, ketamine administered at the end of operation and of control group in postoperative analgesia in children (Tab. 1, Fig. 1, Ref. 21). Full Text (Free, PDF) www.bmj.sk.