Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia
BackgroundOpioid induced hyperalgesia (OIH) is related with high opioid dosage, a long duration of opioid administration, and abrupt discontinuation of infused opioids in anesthetic settings. Ketamine is known to attenuate OIH efficiently, but methods of administration and methods to quantify and as...
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| Format: | Article |
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Korean Society of Anesthesiologists
2015-10-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kjae-68-476.pdf |
| _version_ | 1819014763895586816 |
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| author | Eunji Choi Heeseung Lee Hahck Soo Park Guie Yong Lee Youn Jin Kim Hee-Jung Baik |
| author_facet | Eunji Choi Heeseung Lee Hahck Soo Park Guie Yong Lee Youn Jin Kim Hee-Jung Baik |
| author_sort | Eunji Choi |
| collection | DOAJ |
| description | BackgroundOpioid induced hyperalgesia (OIH) is related with high opioid dosage, a long duration of opioid administration, and abrupt discontinuation of infused opioids in anesthetic settings. Ketamine is known to attenuate OIH efficiently, but methods of administration and methods to quantify and assess a decrease in OIH vary. We demonstrated the existence of remifentanil-induced hyperalgesia and investigated the ability of ketamine to attenuate OIH.MethodsSeventy-five patients undergoing laparoscopic gynecologic surgery under remifentanil-based anesthesia were assigned to one of the following groups: (1) group RL (remifentanil 0.05 µg/kg/min), (2) group RH (remifentanil 0.3 µg/kg/min), or (3) group KRH (remifentanil 0.3 µg/kg/min + ketamine 0.5 mg/kg bolus with 5 µg/kg/min infusion intraoperatively). Desflurane was administered for maintenance of anesthesia to target bispectral index scores (40-60) and hemodynamic parameters (heart rate and blood pressure < ± 20% of baseline values). All parameters related to OIH and its attenuation induced by ketamine were investigated.ResultsThere was no significant difference among the three groups related to demographic and anesthetic parameters except the end-tidal concentration of desflurane. Additional analgesic consumption, numerical rating scale scores at 6 and 24 h, and cumulative fentanyl dose were significantly higher in group RH than in the other two groups. The value difference of the Touch-Test sensory evaluation was significantly higher negative in group RH than in the other two groups.ConclusionsRemifentanil-induced hyperalgesia is significantly attenuated by intraoperative bolus and infusion of ketamine. Ketamine also decreased tactile sensitization, as measured by Touch-Test sensory evaluation. |
| first_indexed | 2024-12-21T02:21:01Z |
| format | Article |
| id | doaj.art-c698f477107141eca2885f7c8fe1bddb |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-21T02:21:01Z |
| publishDate | 2015-10-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-c698f477107141eca2885f7c8fe1bddb2022-12-21T19:19:08ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632015-10-0168547648010.4097/kjae.2015.68.5.4768110Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesiaEunji Choi0Heeseung Lee1Hahck Soo Park2Guie Yong Lee3Youn Jin Kim4Hee-Jung Baik5Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea.BackgroundOpioid induced hyperalgesia (OIH) is related with high opioid dosage, a long duration of opioid administration, and abrupt discontinuation of infused opioids in anesthetic settings. Ketamine is known to attenuate OIH efficiently, but methods of administration and methods to quantify and assess a decrease in OIH vary. We demonstrated the existence of remifentanil-induced hyperalgesia and investigated the ability of ketamine to attenuate OIH.MethodsSeventy-five patients undergoing laparoscopic gynecologic surgery under remifentanil-based anesthesia were assigned to one of the following groups: (1) group RL (remifentanil 0.05 µg/kg/min), (2) group RH (remifentanil 0.3 µg/kg/min), or (3) group KRH (remifentanil 0.3 µg/kg/min + ketamine 0.5 mg/kg bolus with 5 µg/kg/min infusion intraoperatively). Desflurane was administered for maintenance of anesthesia to target bispectral index scores (40-60) and hemodynamic parameters (heart rate and blood pressure < ± 20% of baseline values). All parameters related to OIH and its attenuation induced by ketamine were investigated.ResultsThere was no significant difference among the three groups related to demographic and anesthetic parameters except the end-tidal concentration of desflurane. Additional analgesic consumption, numerical rating scale scores at 6 and 24 h, and cumulative fentanyl dose were significantly higher in group RH than in the other two groups. The value difference of the Touch-Test sensory evaluation was significantly higher negative in group RH than in the other two groups.ConclusionsRemifentanil-induced hyperalgesia is significantly attenuated by intraoperative bolus and infusion of ketamine. Ketamine also decreased tactile sensitization, as measured by Touch-Test sensory evaluation.http://ekja.org/upload/pdf/kjae-68-476.pdfcentral sensitizationhyperalgesiaketamineremifentanil |
| spellingShingle | Eunji Choi Heeseung Lee Hahck Soo Park Guie Yong Lee Youn Jin Kim Hee-Jung Baik Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia Korean Journal of Anesthesiology central sensitization hyperalgesia ketamine remifentanil |
| title | Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia |
| title_full | Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia |
| title_fullStr | Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia |
| title_full_unstemmed | Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia |
| title_short | Effect of intraoperative infusion of ketamine on remifentanil-induced hyperalgesia |
| title_sort | effect of intraoperative infusion of ketamine on remifentanil induced hyperalgesia |
| topic | central sensitization hyperalgesia ketamine remifentanil |
| url | http://ekja.org/upload/pdf/kjae-68-476.pdf |
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