Ketamine Versus Morphine Change Pain Profile
Condition: Acute Pain
MeSH terms: Acute Pain
Study type: Interventional

Summary: 
      The aim of this study is to evaluate the efficacy of intravenous low dose ketamine infusion
      versus morphine infusion analgesia for pain reduction in Abdominoplasty surgery
    

Detailed description: 
      Abdominoplasty is considered one of the most commonly performed cosmetic procedures.
      According to statistics from the International Society of Aesthetic Plastic Surgery, a total
      of 758,590 abdominoplasties were performed in the world in 2016. This is an increase of
      72.95% in comparison with 2011, making it the fourth most common cosmetic procedure. Given
      the increasing number of abdominoplasties performed, the importance of understanding the
      possible complications and morbidity associated with the procedure is critical. One of these
      complications is the postoperative pain. With adequate postoperative pain control, the
      patients met discharge criteria sooner and this helps in shortening the hospital stay, better
      overall patient satisfaction, and decreased hospital costs. Therefore, the severity of this
      problem and the all drug agent used to prevent and treat postoperative pain best interest to
      be aware in the anesthesiologists. Traditionally, analgesia for abdominal wall surgery is
      provided either by systemic drugs such as opioids, nonsteroidal anti-inflammatories, alpha 2
      agonists and paracetamol or by epidural analgesia. However, Opioids, such as morphine or
      fentanyl, remain the mainstay of postoperative analgesic regimens for patients after
      abdominal wall surgery. The pain is not always fully relieved by such agents, and often
      patients develop tolerance to them. The ever-increasing doses of opioids are clearly not
      without their adverse effects. (5) For this Alternative approaches, which reduce the
      requirement for strong opioids post-operative, are required. Recently, interest has focused
      on the use of N-methyl-D-aspartate (NMDA) receptor antagonists for the management of
      postoperative pain. Ketamine exerts its main analgesic effect by antagonism of NMDA receptors
      that not only abolishes peripheral afferent noxious stimulation, but it may also prevent
      central sensitization of nociceptors as shown in animal studies with the excellent analgesic
      property even in subanesthetic doses. (6) Various recently published studies have talked
      about the analgesic effect of low-dose ketamine (7,8) however, all of this study are
      relatively short procedure time, reduced surgical stimulation and small sample size. The aim
      of this study is to evaluate the efficacy of intravenous low dose ketamine infusion versus
      morphine infusion analgesia for pain reduction in Abdominoplasty surgery
    

Intervention name(s): Ketamine; Morphine
Intervention type(s): Drug; Drug
Intervention description(s): Ketamine group to whom intravenous ketamine was administered in a loading dose of 0.15 mg/kg over 5 min, 10 minutes pre incision, followed-by an infusion at 2 micg/kg/min until the end of surgery.; a loading dose of 0.1 mg/kg over 20 min intravenously, 10 minutes pre incision, then infused with morphine an infusion rate of 5 - 40 microgram/kg/hour till the end of surgery.
Other intervention name(s): Ketamine infusion; Morphine infusion
Intervention MeSH terms: Ketamine; Morphine
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: ketamine versus morphine
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment