A Single Small Dose of Postoperative Ketamine Provides Rapid and Sustained Improvement in Morphine Analgesia in the Presence of Morphine-Resistant Pain

Abstract

A small-dose ketamine and morphine regimen interrupted severe postoperative pain that was not relieved previously by morphine. Ketamine reduced morphine consumption and provided rapid and sustained improvement in morphine analgesia and in subjective feelings of well-being, without unacceptable side effects.

Analgesia with Low-Dose S(+)-ketamine in Laparoscopic Cholecystectomy: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

“…The use of low doses of ketamine is associated with a lower incidence of adverse effects and is widely accepted by patients [19]. Therefore, analgesic protocols with fewer adverse effects than those found with the use of opioids should be evaluated [2].…”

The use of dextroketamine as postoperative adjuvant analgesia in a patient undergoing thoracotomy. Case report

“…Currently, dextroketamine is widely used as analgesic therapy adjuvant in humans, in spite of the lack of studies confirming its effectiveness and of discussions with regard to its routine clinical use. Some authors have shown that low dextroketamine doses associated to morphine potentiate analgesia and decrease opioids adverse effects, as well as its ability to decrease pain scores 9 . A large prospective study has shown safety of intravenous dextroketamine and morphine for patient--controlled analgesia 10 .…”

Perioperative pain management in the patient treated with opioids: Continuing Professional Development

“…7 A recent study examined tolerant patients in the recovery room and revealed the beneficial effect of a simple postoperative ketamine bolus to limit acute tolerance to postoperative morphine. 24 Dextromethorphan has similar properties as ketamine, but has been much less studied. Besides ketamine, clonidine and dexmedetomidine have been studied.…”

“…7 Une étude récente s'est penchée sur des patients tolérants en salle de réveil, et a révélé l'intérêt d'un simple bolus postopératoire de kétamine pour limiter la tolérance aiguë à la morphine en postopératoire. 24 Le dextrométorphan présente les mêmes propriétés que la kétamine mais a été beaucoup moins étudié. Outre la kétamine, la clonidine et la dexmedétomi-dine ont fait l'objet d'études.…”