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Canadian Journal of Anesthesia, Vol 33, 16-21, Copyright © 1986 by Canadian Anesthesiologists' Society

Epidural Ketamine for Postoperative Analgesia

MOHAMED NAGUIB MB BCH MSC1, YAW ADU-GYAMFI MB, CHB FFARCS, FWACS1, GAMIL H. ABSOOD PHD1, HESHAM FARAG MB BCH FFARCS1, and HENRY K. GYASI MB CHB FFARCSI1

1 Department of Anesthesiology, King Faisal University, King Fahd Hospital and the Department of Biostatistics, King Faisal University (Dr. Absood)

Address correspondence to: Dr. M. Naguib, Dept. of Anaesthesiology, King Fahd Hospital, P.O. Box 2208, Al-Khobar, 31952, Saudi Arabia.

Thirty-four patients of ASA physical status I or II scheduled for gall bladder surgery were studied in a comparative prospective trial to evaluate the efficacy of epidural and intramuscular ketamine for postoperative pain relief. They were divided randomly into three groups. Group I (11 patients) received 30 mg intramuscular ketamine. Group II (10 patients) and Group III (13 patients) received 10 and 30 mg ketamine in 10 ml saline respectively, through epidural catheters. Pain was evaluated every two hours for the first 24 hours postoperatively by using a linear analogue pain scale from 0-10. Ketamine was given on the patient's request and whenever the pain score exceeded three. Ketamine produced analgesia in all patients studied. The reduction of pain score after two and four hours in Group I and III was significant when compared to Group II. Seven patients (54 per cent) in Group III did not require further analgesia after the initial injection. However, following 10 mg epidural ketamine or 30 mg IM ketamine, postoperative pain was more frequent. Four patients who received epidural ketamine complained of transient burning pain in the back during injection. No patient developed respiratory depression, psychic disturbance, cardiovascular instability, bladder dysfunction or neurologic deficit. It is concluded that 30 mg epidural ketamine is a safe and effective method for postoperative analgesia.

Key Words: ANALGESICS: ketamine • ANAESTHETIC TECHNIQUES: epidural • PAIN: postoperative






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Copyright © 1986 by the Canadian Anesthesiologists' Society.