The
pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience
visceral pain after the former surgery. The aim of this study was to determine the effects of preemptive
ketamine on
visceral pain in patients undergoing gynecological laparoscopic surgery. Ninety patients undergoing gynecological laparoscopic surgery were randomly assigned to one of three groups. Group 1 received placebo. Group 2 was intravenously injected with preincisional saline and local infiltration with 20 mL
ropivacaine (4 mg/mL) at the end of surgery. Group 3 was intravenously injected with preincisional
ketamine (0.3 mg/kg) and local infiltration with 20 mL
ropivacaine (4 mg/mL) at the end of surgery. A standard
anesthetic was used for all patients, and
meperidine was used for postoperative
analgesia. The visual analogue scale (VAS) scores for incisional and
visceral pain at 2, 6, 12, and 24 h, cumulative
analgesic consumption and time until first
analgesic medication request, and adverse effects were recorded postoperatively. The VAS scores of
visceral pain in group 3 were significantly lower than those in group 2 and group 1 at 2 h and 6 h postoperatively (P<0.05 and P<0.01, respectively). At 2 h and 6 h, the VAS scores of incisional
pain did not differ significantly between groups 2 and 3, but they were significantly lower than those in group 1 (P<0.01). Groups 1 and 2 did not show any differences in
visceral pain scores at 2 h and 6 h postoperatively. Moreover, the three groups showed no statistically significant differences in visceral and incisional
pain scores at 12 h and 24 h postoperatively. The consumption of
analgesics was significantly greater in group 1 than in groups 2 and 3, and the time to first request for
analgesics was significantly longer in groups 2 and 3 than in group 1, with no statistically significant difference between groups 2 and 3. However, the three groups showed no significant difference in the incidence of
shoulder pain or adverse effects. Preemptive
ketamine may reduce
visceral pain in patients undergoing gynecological laparoscopic surgery.