EN
Background: Pain after arthroscopic shoulder
surgery is often severe, and establishing a pain treatment
regimen that does not delay discharge can be challenging.
The reported ability of ketamine to prevent opioid-induced
hyperalgesia has not been investigated in this particular
setting. Methods: 300 adult patients scheduled for shoulder
arthroscopy under general anesthesia were recruited
for this observational clinical trial and were allotted to
either receive 1mg/kg IV bolus of ketamine before surgery
(ketamine group, KG) or to a control group (CG) without
ketamine. NRS pain scores were obtained on the operative
day and on postoperative days 1 and 2 and compared
between groups. Secondary variables were blood pressure,
heart rate, process times, satisfaction with the anesthetic
and unwanted effects. Results: Pain severity did not differ significantly between
the groups at any time. Propofol injection rate and cumulative
dose were higher in the KG. Heart rates and blood
pressures were similar. Time to emergence and time in PACU were longer and vomiting was more frequent in
patients given ketamine. Conclusion: Preoperative low-dose ketamine added to
a general anesthetic does not reduce perioperative pain
after outpatient shoulder arthroscopy. It increases procedural
times and the incidence of PONV.