Administration of ketamine during induction and maintenance of anaesthesia in postoperative pain prevention

Introduction

Carcinologic breast surgery is responsible of intermediary postoperative pain and needs 30% additional morphine. Now, morphine administration generates adverse effects. Publications about morphine saving effect of ketalar as antagonist of R-NMDA, administrated in perioperative increase are discussed.

Objective

To evaluate the morphine saving effect of ketalar in carcinologic breast surgery.

Patients and method

This phase III randomized and double-blind study includes 208 patients during 14 months. Surgery consisted in mastectomy with or without axillary lymph node dissection or lumpectomy with axillary lymph node dissection. Group K received ketalar at induction until the end of surgery. Group P (placebo) received physiologic serum in the same condition. During the postoperative first 48 h, morphine's consumption and EN are measured.

Results

No significant difference between two groups was observed. The EN evaluation and morphine consumption remained the same in the two groups. Our results did not find any benefit with use of ketamine between axillary lymph node dissection and no axillary lymph node dissection group.

Conclusion

Ketalar adjunction in our analgesic protocol did not induce significant morphine saving in carcinologic breast surgery.