Pre-emptive Analgesic Efficacy of Low Dose Ketamine versus Magnesium Sulfate in Patients undergoing Major Abdominal Surgeries under General Anaesthesia: A Randomised Clinical Study
UC14-UC17
Correspondence
Surendra Kumar Sethi,
Flat No. 202, Shiv Enclave, Ajmer, Rajasthan, India.
E-mail: drsurendrasethi80@gmail.com
Introduction: Pre-emptive analgesia has been proposed to result in better pain management, reduced analgesic consumption, and improved patient satisfaction.
Aim: To evaluate pre-emptive analgesic efficacy of intravenous ketamine and intravenous magnesium sulfate in patients undergoing major abdominal surgeries under general anaesthesia by administering it 10 minutes before the incision.
Materials and Methods: This randomised, double-blind, clinical study, was conducted in JLN Medical College, Ajmer, Rajasthan, India, from November 2019 to November 2020. The study included 100 patients, aged 18-60 years of American Society of Anaesthesiologist (ASA) physical status I and II were randomly allocated into two groups. Group K (n=50) received intravenous (i.v.) ketamine infusion 0.3 mg/kg in 100 mL normal saline over 10 minutes. Group M (n=50) received i.v. magnesium sulfate (MgSO4) infusion 30 mg/kg in 100 mL normal saline over 10 minutes. The duration of analgesia, total amount of rescue analgesic consumed in 24 hours, haemodynamics, and side-effects were noted. The quantitative data was presented as mean±standard deviation and were compared by student’s t-test.
Results: Duration of analgesia was significantly prolonged in group K (67.96±9.20 min) as compared to group M (30.60±6.44 min) (p-value <0.001). The total dose of rescue analgesic consumption in 24 hours was lesser in group K (1180±388.09) as compared to group M (1280±453.56) (p-value=0.236). Haemodynamics and side-effect profile were comparable in the two groups.
Conclusion: In major abdominal surgeries under general anaesthesia, patients getting ketamine had longer duration of analgesia compared to magnesium sulfate, had an improved quality of recovery after surgery and less serious adverse events in the Postanaesthesia Care Unit (PACU). Ketamine reduces the need for intraoperative opioids and could suppress the pressure response to endotracheal intubation.