The Preemptive Analgesic Effect of Ketamine Used with Fentanyl in Epidural Anesthesia / 대한마취과학회지

ABSTRACT

BACKGROUND: The present study was undertaken to determine whether ketamine, used with fentanyl in epidural anesthesia, can potentiate postoperative analgesia. METHODS: Fifty patients undergoing Cesarean section were allocated randomly into two groups. Group 1 received epidural injection of 2.0% lidocaine 18-20 ml and 0.5% bupivacaine 2-5 ml with fentanyl 50 ug on 20 minutes before surgical incision, and group 2 added epidural ketamine 30 mg to group 1 at the same time. Postoperative pain relief was provided with epidural morphine 3 mg and 0.25% bupivacaine 8 ml on 40 minutes after surgical incision in both groups. Numeric rating scales for pain and mood, Prince Henry Hospital scores for pain were assessed at 2, 6, 12, 24, 48 hours after anesthesia. We measured the first request time of analgesics for postoperative pain, the dose of analgesics within postoperative 48 hours and the incidence of side effects postoperatively. RESULTS: There were no significant difference in the first request time of analgesics and use of analgesics for postoperative pain control between two groups. Pain and mood scores, and PHS score for pain in group 2 were better than those of group 1. The incidence of side effects were similar in both groups. CONCLUSIONS: The combined use of fentanyl and ketamine in epidural anesthesia provided little effect in potentiation of postoperative pain control. Further studies are needed to provide more prominent analgesic effect.