Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Bornemann-Cimenti, H; Wejbora, M; Michaeli, K; Edler, A; Sandner-Kiesling, A.
The effects of minimal-dose versus low-dose S-ketamine on opioid consumption, hyperalgesia, and postoperative delirium: a triple-blinded, randomized, active- and placebo-controlled clinical trial.
Minerva Anestesiol. 2016; 82(10):1069-1076
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Web of Science
PubMed
- Führende Autor*innen der Med Uni Graz
- Bornemann-Cimenti Helmar
- Co-Autor*innen der Med Uni Graz
- Michaeli Kristina Daniela
- Sandner-Kiesling Andreas
- Wejbora Mischa
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- Abstract:
- Evidence confirms that perioperative ketamine administration decreases opioid usage. To reduce the risk for potential psychodysleptic side effects, however, ketamine dosing tends to be limited to low-dose regimens. We hypothesized that even lower doses of ketamine would be sufficient, with minimal side effects, when used as a component of multimodal perioperative pain management. In this triple-blinded, randomized, active- and placebo-controlled clinical trial, patients undergoing elective major abdominal surgery were randomized to one of three treatment groups: low-dose S-ketamine (a 0.25 mg/kg bolus and 0.125 mg/kg/h infusion for 48 hours), minimal-dose S-ketamine (a 0.015 mg/kg/h infusion following a saline bolus), and placebo (saline bolus and infusion). Opioid consumption, pain levels, hyperalgesia at the incision site, and delirium scores were assessed 48 h postoperatively. Patients in the placebo group had the highest cumulative piritramide consumption and the largest normalized areas of hyperalgesia at the incisional site, while those in the low-dose group had the highest delirium scores. Postoperative pain levels did not differ significantly between the treatment groups. Our data demonstrate that minimal-dose S-ketamine was comparable to the conventional low-dose regimen in reducing postoperative opioid consumption and hyperalgesia. Postoperative delirium, however, was less frequent with the minimal-dose regimen. We therefore suggest that minimal-dose S-ketamine may be a useful low-risk component of balanced perioperative analgesia.
- Find related publications in this database (using NLM MeSH Indexing)
- Abdomen - surgery
- Analgesics - administration & dosage
- Analgesics - adverse effects
- Analgesics, Opioid - administration & dosage
- Delirium - diagnosis
- Double-Blind Method -
- Elective Surgical Procedures -
- Female -
- Humans -
- Hyperalgesia - drug therapy
- Ketamine - administration & dosage
- Ketamine - adverse effects
- Male -
- Middle Aged -
- Pain, Postoperative - drug therapy
- Pirinitramide - administration & dosage
- Surgical Wound - complications
- Find related publications in this database (Keywords)
- Ketamine
- Hyperalgesia
- Delirium
- Perioperative period
- Postoperative pain