PURPOSE: The purpose of this study was to compare morphine with ketamine to morphine alone in a double-blind investigation of postsurgical pain control. METHODS:Forty-two ASA 1 and 2 patients undergoing elective microdiscectomy were administered either 1 mg.ml-1 of morphine (n = 20) or 1 mg.ml-1 of both morphine and ketamine (n = 22) via iv patient controlled analgesia (IVPCA). Pain relief and side effects were assessed at 24 hr after surgery. RESULTS: The mean (SD) visual analogue scale (VAS) pain rating of 2.3 (1.67) for patients receiving morphine with ketamine was lower (P < 0.001) than the VAS scores of patients receiving only morphine 4.5 (1.54). Patients receiving morphine and ketamine also had less difficulty with side effects, reporting less nausea (P < 0.05), pruritus (P < 0.001), and urinary retention (P < 0.05). Although dysphoria is reported to be a common side effect of ketamine, complaints of dysphoria were rare in both groups, with only one subject (5%) in the morphine with ketamine group and three (15%) subjects receiving morphine alone reporting this side effect. CONCLUSION:IVPCA ketamine in combination with morphine provides superior postsurgical pain relief at lower dosage and with fewer side effects than morphine alone.
RCT Entities:
PURPOSE: The purpose of this study was to compare morphine with ketamine to morphine alone in a double-blind investigation of postsurgical pain control. METHODS: Forty-two ASA 1 and 2 patients undergoing elective microdiscectomy were administered either 1 mg.ml-1 of morphine (n = 20) or 1 mg.ml-1 of both morphine and ketamine (n = 22) via iv patient controlled analgesia (IVPCA). Pain relief and side effects were assessed at 24 hr after surgery. RESULTS: The mean (SD) visual analogue scale (VAS) pain rating of 2.3 (1.67) for patients receiving morphine with ketamine was lower (P < 0.001) than the VAS scores of patients receiving only morphine 4.5 (1.54). Patients receiving morphine and ketamine also had less difficulty with side effects, reporting less nausea (P < 0.05), pruritus (P < 0.001), and urinary retention (P < 0.05). Although dysphoria is reported to be a common side effect of ketamine, complaints of dysphoria were rare in both groups, with only one subject (5%) in the morphine with ketamine group and three (15%) subjects receiving morphine alone reporting this side effect. CONCLUSION: IVPCA ketamine in combination with morphine provides superior postsurgical pain relief at lower dosage and with fewer side effects than morphine alone.
Authors: Moon Ho Cha; Ji Hye Eom; Yoon Sook Lee; Woon Young Kim; Young Cheol Park; Sam Hong Min; Jae Hwan Kim Journal: Yonsei Med J Date: 2012-03 Impact factor: 2.759
Authors: Too Jae Min; Woon Young Kim; Won Ju Jeong; Jae Ho Choi; Yoon Sook Lee; Jae Hwan Kim; Young Cheol Park Journal: Korean J Anesthesiol Date: 2012-02-20
Authors: Kenneth Jacobsohn; Tanya D Davis; Ahmad M El-Arabi; Jonathan Tlachac; Peter Langenstroer; R Corey O'Connor; Michael L Guralnick; William A See; Robert Schlosser Journal: Can Urol Assoc J Date: 2015 May-Jun Impact factor: 1.862