<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Background and aims</h3><p>Patient-controlled analgesia (PCA) with morphine is commonly used to provide analgesia following major surgery, but is not sufficient as a monotherapy strategy. This study aimed to compare the adjunctive analgesic effect of ketamine versus tramadol on postoperative analgesia provided via PCA-morphine in patients undergoing major upper abdominal surgeries.</p></sec><sec><h3>Methods</h3><p>Forty-two patients undergoing elective major upper abdominal surgery under general anesthesia were allocated to receive either ketamine (load dose of 0.5 mg kg<sup>−1</sup> followed by a continuous infusion of 0.12 mg kg<sup>−1</sup> h<sup>−1</sup> up to 48 postoperative hours; ketamine group, n = 21) or tramadol (load dose of 1 mg kg<sup>−1</sup> followed by a continuous infusion of 0.2 mg kg<sup>−1</sup> h<sup>−1</sup> up to 48 postoperative hours; tramadol group, n = 21) in addition to their standard postoperative analgesia with PCA-morphine. Postoperative data included morphine consumption, visual analog scale (VAS) scores, and side effects during the first 48 postoperative hours after PCA-morphine initiation.</p></sec><sec><h3>Results</h3><p>There were no significant differences in patient demographic and intraoperative data between the two groups. Tramadol group had significantly less total morphine consumption during the first 48 postoperative hours (28.905 [16.504] vs 54.524 [20.846] mg [p &lt; 0.001]) and presented significantly lower VAS scores at rest and mobilization (p &lt; 0.05) than the ketamine group. No statistical difference was recorded between the two groups (p > 0.05) regarding postoperative cough, sedation, hallucinations, pruritus, urine retention, and postoperative nausea and vomiting. However, patients in the ketamine group reported dry mouth more frequently than patients in the tramadol group (p = 0.032).</p></sec><sec><h3>Conclusions</h3><p>Postoperative administration of tramadol was superior to ketamine due to significantly reduced opioid consumption and better pain scores in patients receiving PCA-morphine after major upper abdominal surgery.</p></sec></abstract>

Background and aimsPatient-controlled analgesia (PCA) with morphine is commonly used to provide analgesia following major surgery, but is not sufficient as a monotherapy strategy. This study aimed to compare the adjunctive analgesic effect of ketamine versus tramadol on postoperative analgesia provided via PCA-morphine in patients undergoing major upper abdominal surgeries.MethodsForty-two patients undergoing elective major upper abdominal surgery under general anesthesia were allocated to receive either ketamine (load dose of 0.5 mg kg−1 followed by a continuous infusion of 0.12 mg kg−1 h−1 up to 48 postoperative hours; ketamine group, n = 21) or tramadol (load dose of 1 mg kg−1 followed by a continuous infusion of 0.2 mg kg−1 h−1 up to 48 postoperative hours; tramadol group, n = 21) in addition to their standard postoperative analgesia with PCA-morphine. Postoperative data included morphine consumption, visual analog scale (VAS) scores, and side effects during the first 48 postoperative hours after PCA-morphine initiation.ResultsThere were no significant differences in patient demographic and intraoperative data between the two groups. Tramadol group had significantly less total morphine consumption during the first 48 postoperative hours (28.905 [16.504] vs 54.524 [20.846] mg [p < 0.001]) and presented significantly lower VAS scores at rest and mobilization (p < 0.05) than the ketamine group. No statistical difference was recorded between the two groups (p > 0.05) regarding postoperative cough, sedation, hallucinations, pruritus, urine retention, and postoperative nausea and vomiting. However, patients in the ketamine group reported dry mouth more frequently than patients in the tramadol group (p = 0.032).ConclusionsPostoperative administration of tramadol was superior to ketamine due to significantly reduced opioid consumption and better pain scores in patients receiving PCA-morphine after major upper abdominal surgery.

Ketamine Versus Tramadol as an Adjunct to PCA Morphine for Postoperative Analgesia after Major Upper Abdominal Surgery: A Prospective, Comparative, Randomized Trial

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background and aimsPatient-controlled analgesia (PCA) with morphine is commonly used to provide analgesia following major surgery, but is not sufficient as a monotherapy strategy. This study aimed to compare the adjunctive analgesic effect of ketamine versus tramadol on postoperative analgesia provided via PCA-morphine in patients undergoing major upper abdominal surgeries.MethodsForty-two patients undergoing elective major upper abdominal surgery under general anesthesia were allocated to receive either ketamine (load dose of 0.5 mg kg−1 followed by a continuous infusion of 0.12 mg kg−1 h−1 up to 48 postoperative hours; ketamine group, n = 21) or tramadol (load dose of 1 mg kg−1 followed by a continuous infusion of 0.2 mg kg−1 h−1 up to 48 postoperative hours; tramadol group, n = 21) in addition to their standard postoperative analgesia with PCA-morphine. Postoperative data included morphine consumption, visual analog scale (VAS) scores, and side effects during the first 48 postoperative hours after PCA-morphine initiation.ResultsThere were no significant differences in patient demographic and intraoperative data between the two groups. Tramadol group had significantly less total morphine consumption during the first 48 postoperative hours (28.905 [16.504] vs 54.524 [20.846] mg [p  0.05) regarding postoperative cough, sedation, hallucinations, pruritus, urine retention, and postoperative nausea and vomiting. However, patients in the ketamine group reported dry mouth more frequently than patients in the tramadol group (p = 0.032).ConclusionsPostoperative administration of tramadol was superior to ketamine due to significantly reduced opioid consumption and better pain scores in patients receiving PCA-morphine after major upper abdominal surgery.

Background and aimsPatient-controlled analgesia (PCA) with morphine is commonly used to provide analgesia following major surgery, but is not sufficient as a...

Ketamine Versus Tramadol as an Adjunct to PCA Morphine for Postoperative Analgesia after Major Upper Abdominal Surgery: A Prospective, Comparative, Randomized Trial

Article Category: Research Article

Publié en ligne: 10 août 2020

Pages: 43 - 51

DOI: https://doi.org/10.2478/rjaic-2020-0005

Mots clés
Ketamine, tramadol, morphine, postoperative analgesia

© 2020 Paraskevi K. Matsota et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Ketamine Versus Tramadol as an Adjunct to PCA Morphine for Postoperative Analgesia after Major Upper Abdominal Surgery: A Prospective, Comparative, Randomized Trial

Article Category: Research Article

Publié en ligne: 10 août 2020

Pages: 43 - 51

DOI: https://doi.org/10.2478/rjaic-2020-0005

Mots clésKetamine, tramadol, morphine, postoperative analgesia

© 2020 Paraskevi K. Matsota et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
Ketamine, tramadol, morphine, postoperative analgesia