Effects of Perioperative Low Dose Ketamine Infusion on Postoperative Pain Perception in Males and Females Undergoing Laparoscopic Surgery
Abstract
Fifty to 75% of patients report that postoperative pain management is grossly inadequate. A contributing factor to this analgesic deficit may be hyperalgesia, a phenomenon whereby the intensity and duration of painful stimuli are enhanced. Activation of the N-methyl-D-aspartate (NMDA) receptor due to surgical insult has been shown to initiate and maintain central sensitization , the hyperexcitable state within the central nervous system the produces hyperalgesia. Ketamine, an NMDA receptor antagonist, administered preemptively may inhibit central sensitization and thereby reduce postoperative pain perception. Further, the efficacy of ketamine may be influenced by sex or gender differences that have not been clearly elucidated. In this 2 X 2 factorial, double blind, placebo-controlled study, 37 female and 18 male (N =55) ASA 1-3 participants who underwent elective laparoscopic surgery were randomiy assigned to receive either a perioperative low dose ketamine infusion at 3.125 mcg/kg/min or a saline infusion at the same rate. Early pain perception was measured by time to first request (TTFR) for analgesic medication. Prolonged pain perception was derived from participants' 24-hour opioid consumption. The 100 millimeter visual analogue scale (VAS) measured pain perception at the following four time points, time to first request for an analgesic, 30 minutes after arrival in the postanesthesia care unit (PACU), at time of discharge from PACU, and 24 hours after termination of the perioperative infusion. No significant demographic differences among groups (p> .05) were found. Further, no significant differences were found among groups with regard to TTFR, 24-hour opioid equivalent usage or repeated measures pain perception, using the VAS. However, a significant difference in TTFR (p, .49) was found in females in the luteal phase of the menstrual cycle when compared to women in the follicular phase or nonmenstruating women and men. ,,, nonmenstruating women and men.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2003
- Accession Number
- ADA427132
Entities
People
- Jeffrey P. Conroy
- Warren T. Cusick
Organizations
- University of Texas Health Science Center at Houston