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Beneficial Effects of Adding Ketamine to Intravenous Patient-Controlled Analgesia with Fentanyl after the Nuss Procedure in Pediatric Patients

Authors
Cha, Moon HoEom, Ji HyeLee, Yoon SookKim, Woon YoungPark, Young CheolMin, Sam HongKim, Jae Hwan
Issue Date
1-3월-2012
Publisher
YONSEI UNIV COLL MEDICINE
Keywords
Fentanyl; funnel chest; ketamine; patient-controlled analgesia; pediatrics
Citation
YONSEI MEDICAL JOURNAL, v.53, no.2, pp.427 - 432
Indexed
SCIE
SCOPUS
KCI
Journal Title
YONSEI MEDICAL JOURNAL
Volume
53
Number
2
Start Page
427
End Page
432
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/105315
DOI
10.3349/ymj.2012.53.2.427
ISSN
0513-5796
Abstract
Purpose: The aim of this prospective, double-blind, randomized study was to investigate the analgesic effects of low-dose ketamine on intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control in pediatric patients following the Nuss procedure for pectus excavatum. Materials and Methods: Sixty pediatric patients undergoing the Nuss procedure were randomly assigned to receive fentanyl (Group F, n=30) or fentanyl plus ketamine (Group FK, n=30). Ten minutes before the end of surgery, following the loading dose of each solution, 0.5 pg/kg/hr of fentanyl or 0.5 mu g/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, I mL/hr; bolus, 0.5 mL; lock out interval, 30 min). Fentanyl consumption, pain score, ketorolac use, nausea/vomiting, ondansetron use, pruritus, respiratory depression, hallucination, dreaming, and parent satisfaction with pain control were measured throughout the 48 hours following surgery. Results: The pain scores, ketorolac use, and fentanyl consumption of Group FK were significantly lower than in Group F (p<0.05). The incidence of nausea/vomiting and ondansetron use in Group FK was significantly lower than in Group F (p<0.05). There were no reports of respiratory depression, hallucination or dreaming. Parent satisfaction with pain control was similar between the two groups. Conclusion: We concluded that low-dose ketamine added to IV-PCA with fentanyl after the Nuss procedure in pediatric patients can reduce pain scores, consumption of fentanyl, and incidence of nausea/vomiting without increasing side effects.
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