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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2017 Oct 04

DOI: 10.23736/S0375-9393.17.12115-2


lingua: Inglese

Preventative effect of ketamine on post-surgical hyperalgesia induced at a body part remote from the surgical site: a randomized controlled trial

Young-Eun MOON, Mi-Hyun KIM , Hyung-Mook LEE, Hyo-Min YOON, Young-Jae JEON

Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea


BACKGROUND: It is known that pain hypersensitivity can be induced at a body part remote from a surgical site (tertiary hyperalgesia), leading to patient discomfort. Nevertheless, no reported study to date has investigated methods to attenuate such tertiary hyperalgesia. Ketamine is known to modulate hyperalgesia induced by central sensitization. Thus, we investigated whether intraoperative administration of ketamine could decrease post-surgical tertiary hyperalgesia in patients undergoing a laparoscopic hysterectomy.
METHODS: In total 46 patients were studied. Ketamine (1 mg/kg i.v. and 0.5 mg/kg/h or the same volume of 0.9% saline) was administered during surgery in the ketamine and control groups, respectively. The mechanical pain threshold was measured on the patients’ dominant palm before and 24 h after the surgery to evaluate hyperalgesia.
RESULTS: The change in mechanical pain threshold over time (preoperative and postoperative) differed between the groups, with a lower postoperative threshold in the control group [118.6 (170.5) vs. 419.2 (233); P = 0.015]. The postoperative visual analogue scale score at rest was lower in the ketamine group [22 (16) vs. 13 (9); P = 0.02]. Visual analogue scale scores during deep breathing, consumption of analgesia and antiemetics, and the incidence of dizziness did not differ significantly between the groups (P > 0.05).
CONCLUSIONS: These results suggest that the intraoperative administration of ketamine may decrease post-surgical hyperalgesia developing at a region remote from the surgical site.

KEY WORDS: Central nervous system sensitization - Hyperalgesia - Ketamine

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Publication History

Article first published online: October 04, 2017
Manuscript accepted: September 26, 2017
Manuscript revised: September 12, 2017
Manuscript received: April 1, 2017

Per citare questo articolo

Moon YE, Kim MH, Lee HM, Yoon HM, Jeon YJ. Preventative effect of ketamine on post-surgical hyperalgesia induced at a body part remote from the surgical site: a randomized controlled trial. Minerva Anestesiol 2017 Oct 04. DOI: 10.23736/S0375-9393.17.12115-2

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