Abstract

GONZALEZ-PEREZ, S. F.. Epidural ketamine in low abdominal surgery. Rev. Soc. Esp. Dolor [online]. 2006, vol.13, n.3, pp.145-150. ISSN 1134-8046.

Introduction: Ketamine is a drug used for induction and maintenance of anesthesia, exists as a racemic mixture of R- and S+-enantiomers. Epidural ketamine starts to human administration about 80’ years. After that, various studies have been published about the mechanism of analgesic action of ketamine: lamina-specific suppression of dorsal-horn unit activity (1), opiate agonist at the spinal level in the same way as opioids (2) and non-competitive N-methyl-D-aspar-tate NMDA receptor antagonist (3). Purpose: To evaluate the efficacy of epidural ketamine for postoperative pain relief in lower abdominal procedures.  Materials and Methods: 50 patients undergoing inguinal herniotomy were studied in a comparative propective trial. They were divided into two groups to receive epidural ketamine 50 mg or epidural morphine 2 mg.  Results: Epidural ketamine in doses to 50 mg provide adequate analgesia during 6 hours. Morphine administered epidurally obtained analgesia more than 18 hours.  Conclusion: Epidurally administered ketamine is less effective than epidural morphine for postoperative analgesia, but it playes an important role in morphine-induced analgesia and during the combination with local anaesthetic.

Keywords : Ketamine; Epidural Space; Postoperative Analgesia.

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