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Year :2016
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Month :
July-August
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Volume :
5
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Issue :
3
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Page :
-
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Evaluation of Low-Dose Ketamine Pretreatment to Reduce Propofol Injection Pain: A Randomised, Double-Blind, Controlled Trial
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Correspondence Address :
Deepa Ravindra Shriyan, Bhas kar Murlidhar PaPatil,
Dr. Deepa Ravindra Shriyan,
1104 Raj Heritage Tower, L.M. Road, Borivali (West),
Mumbai-400103, India.
E-mail: doctordeepas@yahoo.co.in
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Introduction: Introduction: Propofol is a widely used intravenous anaesthetic that is known to cause distressing local pain at the site of injection. Several methods to attenuate this pain with varying efficacy have been described.Ketamine pretreatment is one of the methods proposed to reduce attenuate propofol injection pain due to its local anaesthetic properties.
Aim: To determine if low-dose ketamine could reduce propofol injection pain in dorsal hand vein. To study haemodynamic effects of this combination of drugs, and to know if any untoward effects like emergence phenomenon occur on administering low-dose ketamine.
Settings and Design: A prospective, randomised, double-blind, placebo-controlled study in a Public Health institute.
Materials and Methods: In this prospective, randomised, double-blind, placebo-controlled study,60 ASA 1 and 2 patients with ages from 18 to 65 years, scheduled for minor gynaecologic surgery under total intravenous anaesthesia were randomly allocated into two groups (A and B). After obtaining written, valid and informed consent, patients in group A received ketamine as the pretreatment before receiving propofol. Those in group B received saline before administration of propofol. Pain scores were measured by the investigator immediately following injection of propofol. All patients’ responses were graded by a verbal pain score.
Statistical Analysis: Results were analyzed using t-test, and Chi-square tests.
Results: It was noted that low-dose ketamine was effective in reducing the incidence of pain from 93.3% in the control group to 20% in patients administered ketamine. The intensity of pain was also reduced in the ketamine group, as none of the patients experienced severe pain as compared to 33.30% in control group. Ketamine did not produce any emergence phenomenon or any other side effects at this low dose.
Conclusion: Low-dose ketamine pretreatment is useful in significantly reducing the incidence of pain on injection of propofol. Haemodynamics are preserved for a short interval after administration of propofol, which was more useful when compared to placebo administration. Ketamine does not produce any emergence or side effects in low dose.
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