J Korean Pain Soc.
1999 Nov;12(2):205-210.
The Effect of Epidural Low Dose Ketamine Plus Morphine on the Postoperative Pain Control
- Affiliations
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- 1Department of Anesthesiology, Eulji General Hospital, Eulji Medical College, Seoul, Korea.
Abstract
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BACKGROUND: Epidural morphine for postoperative pain control has a serious risk of respiratory
depression and other side effects such as pruritus, nausea and urinary retention, In recent
years, it is known that epidural administration of ketamine potentiates the effect of epidural
morphine, and so decrease the side effects of epidural morphine. This study was performed to
evaluate the analgesic efficacy of epidurally administered ketamine and whether this epidural
administration can decrease the amount of epidural morphine.
METHODS
Sixty patients scheduled for the elective cesarean section were randomly selected.
All patients were given subarachnoid injection of tetracaine 9 mg. Group I received epidural
bolus injection of 0.15% bupivacaine 10 ml with morphine 2 mg followed by a continuous infusion
of 0.125% bupivacaine 100 ml containing morphine 4 mg after peritoneum closure, and group II
received the same method as group I except for the addition of epidural ketamine 30 mg.
Analgesic effects were assessed using Numeric Rating Score (NRS) and Prince Henry Score (PHS).
Also, the degree of satisfaction and the incidence of the side effects were observed.
RESULTS
Analgesic effects were significant in both groups after drug administration. But NRS
and PHS were not significantly different between two groups at all times. The incidence of
nausea and vomiting was 11 out of 30 in group I and 9 out of 30 in group II and the incidence
of itching was ll out of 30 in group I and 8 out of 30 in group II, Number of patients using
additional analgesics were 2 and 1 in group I and II, respectively.
CONCLUSIONS
Epidural ketamine did not potentiate the analgesic effect of epidural motphine
and could not decrease the side effect of epidural morphine.