TITLE:
Early and Late Postoperative Pain and Side Effects after Mastectomy: A Comparison of Ketamine and Thiamylal Administered for Anesthetic Induction
AUTHORS:
Tadasuke Use, Tetsuya Sakai, Hiroko Shimamoto, Taku Fukano, Koji Sumikawa
KEYWORDS:
Preventive Analgesia; Ketamine; Mastectomy; Postoperative Pain; Anesthetic Induction
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.3,
May
24,
2013
ABSTRACT: Objective: To compare acute and long-term
postoperative pain and side effects in patients undergoing mastectomy for
breast cancer under general anesthesia induced with ketamine or thiamylal. Methods: Twenty four ASA physical status I-III patients undergoing mastectomy were
randomly assigned to one of two groups. Ketamine group received intravenous ketamine, 1 mg/kg, and thiamylal
group received intravenous thiamylal, 4 mg/kg, at the induction of general anesthesia. Anesthesia was maintained
with sevoflurane, N2O and fentanyl. The intensity of pain was
assessed by using visual analog scale (VAS) 3 and 16 hr and 2, 3 and 4 weeks after surgery. Postoperative
side effects, including nausea, vomiting and hallucination were also recorded. Results: At 16 hr after surgery, VAS in
ketamine group was significantly lower than that in thiamylal group. However, there were no
statistically significant differences between the two groups in the VAS at 3 hr
and 2, 3 and 4 weeks after surgery. There were no differences in the incidence
of side effects such as nausea, vomiting and hallucination between the two
groups. Conclusion: Intravenous
ketamine at the induction of anesthesia could reduce acute postoperative pain
but not long-term pain after mastectomy.