G.H.I.T.T.N.(2008) No morphine sparing effect of ketamine added to morphine for patient-controlled intravenous analgesia after uterine artery embolization Acta Anaesthesiologica Scandinavica 52 (4) , 479-486 doi:10.01602.Abstract NO MORPHINE SPARING EFFECT OF KETAMINE ADDED TO MORPHINE FOR PATIENT-CONTROLLED INTRAVENOUS ANALGESIA AFTER UTERINE ARTERY EMBOLIZATION L.JENSEN, G.S.I.T.T.And N.1Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, DK-5000 Odense C, Denmark and 2Department of Obstetrics and Gynaecology Odense University Hospital, DK-5000 Odense C, Denmark Address: _L.Jensen_ Department of Anaesthesiology and Intensive Care Medicine Vejle Hospital DK-7100 Vejle Denmark e-mail: Present address: Private Skjoldborgsvej 1, DK-8723 Lsning, Denmark.ABSTRACT Background: Pain following embolization of the uterine arteries (UAEs) is variable and may be very severe requiring large doses of parenteral opioids for relief.Present study tested the hypothesis that the addition of ketamine to IV patient-controlled morphine reduces the amount of morphine required for pain-control during the first 24 h after UAE embolization.Methods: Fifty-six patients undergoing UAE embolization for treatment of symptomatic uterine leiomyomata were randomized to receive either 2 mg/ml of morphine (Control group, _n_=30) or 2 mg/ml of both morphine and ketamine (Ketamine group, _n_=26) by IV patient-controlled analgesia (IV-PCA).Settings were bolus dose 1 ml, lockout 10 min, no background infusion.Addition, all patients received diclofenac and acetaminophen for pain relief.Scores, morphine consumption and adverse events like nausea, vomiting, itching, visual disturbances, anxiety, dreaming and hallucinations, if any, were recorded for 24 h after embolization.The mean SD 24-h consumption of patient-controlled morphine was 38.Mg in the Ketamine group vs.18.In the Control group (NS).Difference between the means was 5.(95% confidence interval: -5. One patient in the Ketamine group vs.In the Control group experienced auditory hallucinations.Conclusion: Studying an unselected group of patients undergoing embolization of the UAEs for treatment of symptomatic uterine leiomyomata under conditions of basal analgesia with acetaminophen and diclofenac, we failed to demonstrate any morphine-sparing effect of IV-PCA ketamine and morphinepared with IV-PCA morphine alone.THIS ARTICLE IS CITED BY: J.(2008) The ketamine enigma.Anaesthesiologica Scandinavica_ 52:4, 453-455 THIS ARTICLE SEARCH InSynergyPubMed (MEDLINE)CrossRefBy keywordsKetaminemorphinemorphine-sparing effectsBy authorL. HANDBERGH.HELBO-HANSENI.LOHSET.Read more Paracetamol (acetaminophen) esters of some non-steroidal anti-inflammatory carboxylic acids as mutual prodrugs with improved therapeutic index
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