PREEMPTIVE KETAMINE DECREASES POSTOPERATIVE NARCOTIC REQUIREMENTS IN PATIENTS UNDERGOING ABDOMINAL-SURGERY

The aim of this study was to determine if preemptive administration of systemic ketamine decreases postoperative pain when compared with pos twound closure administration of ketamine. Patients undergoing abdomin al procedures were randomized into a preemptive or postwound closure k etamine administration group. Before surgical incision, patients in th e preemptive group (n = 20) were given 0.5 mg/kg ketamine followed by a ketamine infusion of 10 mu g.kg(-1).min(-1), which was discontinued at abdominal closure. The patients in the postwound closure (n = 20) g roup were given 0.5 mg/kg of ketamine immediately after abdominal clos ure. Postoperatively, all patients received intravenous (IV) morphine in the postanesthesia care unit (PACU) and were started on IV morphine patient-controlled analgesia after discharge from the PACU. Postopera tive pain was assessed by measuring morphine consumption and visual an alog scale (0-100 mm) pain scores at rest. Patients in the preemptive group had significantly lower morphine consumption on postoperative Da ys 1 and 2. No significant intergroup differences were seen in the pai n scores throughout the study period. Preemptive ketamine decreased po stoperative opioid requirements, which was observed long after the nor mal expected duration of ketamine.