Pre-emptive intravenous ketamine analgesia in patients undergoing laparoscopic cholecystectomy: A prospective double blind randomised controlled trial

Shir Siong Wang, Nurlia Yahya, Tang Suet Ping Shereen, Maryam Budiman, Aliza Mohamad Yusof, Muhammad Zurrusydi Zainuddin, Nadia Md Nor, Siew Kiau Lim

Research output: Contribution to journalArticle

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Abstract

Introduction: Pre-emptive analgesia is a technique that is initiated before noxious stimuli is experienced and has been shown to lower the pain intensity when compared to analgesics administered after the surgical incision. As previous studies were inconclusive in determining the optimal dose, this prospective double blind randomised controlled trial was carried out to evaluate if pain could be alleviated when comparing low doses of intravenous ketamine for pre-emptive analgesia. Materials and Methods: Seventy eight patients undergoing laparoscopic cholecystectomy were prospectively recruited and randomised into 3 groups after obtaining written consent: Group 1 (placebo); Group 2 (IV ketamine 0.25 mg/kg); and Group 3 (IV ketamine 0.5 mg/kg). All study drugs were given 5 minutes after endotracheal intubation prior to surgical incision. Blood pressure and heart rate were recorded before and after induction of anaesthesia and subsequently at 5 minute intervals for 30 minutes after the study drug was given. Post-operative pain control was evaluated through visual analogue scale (VAS) at 0, 3, 6, 12 and 24 hours post-operatively. Any adverse effects of ketamine were documented. Results: Group 3 patients had significantly lower VAS scores at 0, 3, 6 and 24 hours post-operatively compared to patients in Group 1. Groups 1 and 2 patients did not have significantly different VAS scores throughout the study period. Haemodynamic parameters including heart rate and mean arterial pressure were not significantly different among the three groups. Side effects documented were nausea, vomiting and blurring of vision. Conclusion: IV ketamine 0.5 mg/kg showed significant pre-emptive analgesic effects when compared to IV ketamine 0.25 mg/kg and placebo, in patients undergoing laparoscopic cholecystectomy.

Original languageEnglish
Pages (from-to)288-296
Number of pages9
JournalBrunei International Medical Journal
Volume11
Issue number6
Publication statusPublished - 2015

Fingerprint

Laparoscopic Cholecystectomy
Ketamine
Analgesia
Randomized Controlled Trials
Visual Analog Scale
Pain
Analgesics
Heart Rate
Placebos
Intratracheal Intubation
Pharmaceutical Preparations
Nausea
Vomiting
Arterial Pressure
Anesthesia
Hemodynamics
Blood Pressure

Keywords

  • Adverse effects
  • Analgesia
  • Ketamine
  • Laparoscopic cholecystectomy
  • Pain relief

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pre-emptive intravenous ketamine analgesia in patients undergoing laparoscopic cholecystectomy : A prospective double blind randomised controlled trial. / Wang, Shir Siong; Yahya, Nurlia; Shereen, Tang Suet Ping; Budiman, Maryam; Mohamad Yusof, Aliza; Zainuddin, Muhammad Zurrusydi; Md Nor, Nadia; Lim, Siew Kiau.

In: Brunei International Medical Journal, Vol. 11, No. 6, 2015, p. 288-296.

Research output: Contribution to journalArticle

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abstract = "Introduction: Pre-emptive analgesia is a technique that is initiated before noxious stimuli is experienced and has been shown to lower the pain intensity when compared to analgesics administered after the surgical incision. As previous studies were inconclusive in determining the optimal dose, this prospective double blind randomised controlled trial was carried out to evaluate if pain could be alleviated when comparing low doses of intravenous ketamine for pre-emptive analgesia. Materials and Methods: Seventy eight patients undergoing laparoscopic cholecystectomy were prospectively recruited and randomised into 3 groups after obtaining written consent: Group 1 (placebo); Group 2 (IV ketamine 0.25 mg/kg); and Group 3 (IV ketamine 0.5 mg/kg). All study drugs were given 5 minutes after endotracheal intubation prior to surgical incision. Blood pressure and heart rate were recorded before and after induction of anaesthesia and subsequently at 5 minute intervals for 30 minutes after the study drug was given. Post-operative pain control was evaluated through visual analogue scale (VAS) at 0, 3, 6, 12 and 24 hours post-operatively. Any adverse effects of ketamine were documented. Results: Group 3 patients had significantly lower VAS scores at 0, 3, 6 and 24 hours post-operatively compared to patients in Group 1. Groups 1 and 2 patients did not have significantly different VAS scores throughout the study period. Haemodynamic parameters including heart rate and mean arterial pressure were not significantly different among the three groups. Side effects documented were nausea, vomiting and blurring of vision. Conclusion: IV ketamine 0.5 mg/kg showed significant pre-emptive analgesic effects when compared to IV ketamine 0.25 mg/kg and placebo, in patients undergoing laparoscopic cholecystectomy.",
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AU - Wang, Shir Siong

AU - Yahya, Nurlia

AU - Shereen, Tang Suet Ping

AU - Budiman, Maryam

AU - Mohamad Yusof, Aliza

AU - Zainuddin, Muhammad Zurrusydi

AU - Md Nor, Nadia

AU - Lim, Siew Kiau

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N2 - Introduction: Pre-emptive analgesia is a technique that is initiated before noxious stimuli is experienced and has been shown to lower the pain intensity when compared to analgesics administered after the surgical incision. As previous studies were inconclusive in determining the optimal dose, this prospective double blind randomised controlled trial was carried out to evaluate if pain could be alleviated when comparing low doses of intravenous ketamine for pre-emptive analgesia. Materials and Methods: Seventy eight patients undergoing laparoscopic cholecystectomy were prospectively recruited and randomised into 3 groups after obtaining written consent: Group 1 (placebo); Group 2 (IV ketamine 0.25 mg/kg); and Group 3 (IV ketamine 0.5 mg/kg). All study drugs were given 5 minutes after endotracheal intubation prior to surgical incision. Blood pressure and heart rate were recorded before and after induction of anaesthesia and subsequently at 5 minute intervals for 30 minutes after the study drug was given. Post-operative pain control was evaluated through visual analogue scale (VAS) at 0, 3, 6, 12 and 24 hours post-operatively. Any adverse effects of ketamine were documented. Results: Group 3 patients had significantly lower VAS scores at 0, 3, 6 and 24 hours post-operatively compared to patients in Group 1. Groups 1 and 2 patients did not have significantly different VAS scores throughout the study period. Haemodynamic parameters including heart rate and mean arterial pressure were not significantly different among the three groups. Side effects documented were nausea, vomiting and blurring of vision. Conclusion: IV ketamine 0.5 mg/kg showed significant pre-emptive analgesic effects when compared to IV ketamine 0.25 mg/kg and placebo, in patients undergoing laparoscopic cholecystectomy.

AB - Introduction: Pre-emptive analgesia is a technique that is initiated before noxious stimuli is experienced and has been shown to lower the pain intensity when compared to analgesics administered after the surgical incision. As previous studies were inconclusive in determining the optimal dose, this prospective double blind randomised controlled trial was carried out to evaluate if pain could be alleviated when comparing low doses of intravenous ketamine for pre-emptive analgesia. Materials and Methods: Seventy eight patients undergoing laparoscopic cholecystectomy were prospectively recruited and randomised into 3 groups after obtaining written consent: Group 1 (placebo); Group 2 (IV ketamine 0.25 mg/kg); and Group 3 (IV ketamine 0.5 mg/kg). All study drugs were given 5 minutes after endotracheal intubation prior to surgical incision. Blood pressure and heart rate were recorded before and after induction of anaesthesia and subsequently at 5 minute intervals for 30 minutes after the study drug was given. Post-operative pain control was evaluated through visual analogue scale (VAS) at 0, 3, 6, 12 and 24 hours post-operatively. Any adverse effects of ketamine were documented. Results: Group 3 patients had significantly lower VAS scores at 0, 3, 6 and 24 hours post-operatively compared to patients in Group 1. Groups 1 and 2 patients did not have significantly different VAS scores throughout the study period. Haemodynamic parameters including heart rate and mean arterial pressure were not significantly different among the three groups. Side effects documented were nausea, vomiting and blurring of vision. Conclusion: IV ketamine 0.5 mg/kg showed significant pre-emptive analgesic effects when compared to IV ketamine 0.25 mg/kg and placebo, in patients undergoing laparoscopic cholecystectomy.

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KW - Analgesia

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KW - Laparoscopic cholecystectomy

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