COMMENTARY

Postoperative Ketamine Can Reduce Morphine Consumption and Nausea


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This is the Medscape Medical Minute. I'm Dr. George Lundberg.

The animal tranquilizer ketamine, like phencyclidine (PCP), produces a "dissociative anesthesia." Could it be useful clinically? Seven French investigators report in the journal Anesthesia and Analgesia in 2008 on a prospective, randomized, double-blind, controlled trial of 81 patients with major abdominal surgery.[1] They administered ketamine intra- and postoperatively for 48 hours in the first experimental group, only intraoperatively in group 2, and group 3 received placebo only. Cumulative morphine consumption 24 hours after surgery in group 1 was cut to half of the control group and group 2 cut to 80%. Also, 27% of the control group experienced nausea vs only 4% in the experimental ketamine group 1. No adverse effects were noted. The authors conclude that low-dose ketamine during and after abdominal surgery improves analgesia and nausea and decreases the need for morphine.

This article is selected from Medscape Best Evidence.[2] I'm Dr. George Lundberg.


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