Preemptive Analgesic Effect of Ketamine in Children with Lower Abdominal Surgery

Abstract

Objective: Preemptive analgesic effect of low dose ketamine has been supported by clinical studies in adults. The aim of this study was to evaluate the analgesic effect of ketamine applied at different times in children who underwent lower abdominal surgery. Material and Methods: A total of 90 children having ASAI-II physical status between 3 and 12 was randomly divided into three groups as pre, int and post groups. Ketamine were given to these groups in the following manner respectively; 1mg/kg intravenous ketamine before incision (pre-incisional); the same dose ketamine 10 minutes following the first incision (intraoperative); and ketamine at the end of the surgical operation (postoperative). The pain of patients was assessed by postoperative pain scale (CHIPPS) in children and infants; the sedation status of children was assessed by Ramsey's sedation scale. The first analgesic requirement time was recorded. Results: No significant difference was found in demographic characteristics of the three groups (p>0.05). Lower CHIPPS scores were found in Group Post throughout all measurement periods (p<0.05). Group Post was found to have significantly higher sedation levels compared with the other two groups (p=0.003). Conclusion: No analgesic effect was obtained using by pre-incisional and intraoperative i.v.1mg/kg ketamine, during lower abdominal surgery in children. Further studies with different drugs are needed to clarify this topic.