Beneficial effects of adding ketamine to intravenous patient-controlled analgesia with fentanyl after the Nuss procedure in pediatric patients.

Abstract

PURPOSE:

The aim of this prospective, double-blind, randomized study was to investigate the analgesic effects of low-dose ketamine on intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control in pediatric patients following the Nuss procedure for pectus excavatum.

MATERIALS AND METHODS:

Sixty pediatric patients undergoing the Nuss procedure were randomly assigned to receive fentanyl (Group F, n=30) or fentanyl plus ketamine (Group FK, n=30). Ten minutes before the end of surgery, following the loading dose of each solution, 0.5 μg/kg/hr of fentanyl or 0.5 μg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 mL/hr; bolus, 0.5 mL; lock out interval, 30 min). Fentanyl consumption, pain score, ketorolac use, nausea/vomiting, ondansetron use, pruritus, respiratory depression, hallucination, dreaming, and parent satisfaction with pain control were measured throughout the 48 hours following surgery.

RESULTS:

The pain scores, ketorolac use, and fentanyl consumption of Group FK were significantly lower than in Group F (p<0.05). The incidence of nausea/vomiting and ondansetron use in Group FK was significantly lower than in Group F (p<0.05). There were no reports of respiratory depression, hallucination or dreaming. Parent satisfaction with pain control was similar between the two groups.

CONCLUSION:

We concluded that low-dose ketamine added to IV-PCA with fentanyl after the Nuss procedure in pediatric patients can reduce pain scores, consumption of fentanyl, and incidence of nausea/vomiting without increasing side effects.

• Authors: Moon Ho Cha, Ji Hye Eom, Yoon Sook Lee, Woon Young Kim, Young Cheol Park, Sam Hong Min, Jae Hwan Kim
• Journal: Yonsei medical journal (Yonsei Med J) Vol. 53 Issue 2 Pg. 427-32 (Mar 2012) ISSN: 1976-2437 [Electronic] Korea (South)
• PMID: 22318834 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics
• Ketamine
• Fentanyl

Topics

• Analgesia, Patient-Controlled (methods)
• Analgesics (therapeutic use)
• Child
• Double-Blind Method
• Female
• Fentanyl (therapeutic use)
• Funnel Chest (surgery)
• Humans
• Injections, Intravenous
• Ketamine (therapeutic use)
• Male
• Pain, Postoperative (drug therapy)