S(+)-ketamine for control of perioperative pain and prevention of Post Thoracotomy Pain Syndrome: a randomized, double-blind study Full Text
Minerva Anestesiologica, 06/26/2012
Mendola C et al. – S(+)–ketamine had no effects in respect to placebo in the prevention of post–thoracotomy pain syndrome (PTPS) at 3 and 6months but had a significant role in maintaining a Numeric Rating Scale (NRS)≤3 in the early postoperative period. A tight control of perioperative pain seems to be associated with a low incidence of moderate and severe PTPS.Methods
- Sixty–six patients underwent thoracotomy under general anesthesia.
- A thoracic epidural catheter was placed for levobupivacaine and sufentanil administration.
- Thirty–three patients received an i.v. infusion of S(+)–ketamine (Group S(+)K) for 60hours and 33 patients received i.v. placebo (Group PLAC).
- Pain was evaluated by Numeric Rating Scale (NRS) during the whole study.
- All patients had supplementary doses of analgesics, as needed, to have NRS targeted to a value of ≤3 in the 1st and <3 in the following days.
- Neuropathic Pain Symptom Inventory (NPSI) was evaluated at 1, 3 and 6months.
- All patients had NRS ≤3 in the early postoperative period and NPSI was less or equal to 1 in the follow–up control for each group with no significant difference at three (P=0.67, OR 0.8 [IC95% 0.3–2.2]) and at six months (P=0.23, OR 1.9 [0.7–5.4]).
- Incidence of moderate PTPS was 24.6% at 3 and 21.1% at six months while severe PTPS was 6.6% at 3 and 1.8% at six months.
- No difference was detected in NRS and NPSI at 3 and 6months between groups.