Beneficial effects of adding ketamine to intravenous patient-controlled analgesia with fentanyl after the nuss procedure in pediatric patients

Moon Ho Cha, Ji Hye Eom, Yoon Sook Lee, Woon Young Kim, Young Cheol Park, Sam Hong Min, Jae Hwan Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

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 μg/kg/hr of fentanyl or 0.5 μg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 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.

Original languageEnglish
Pages (from-to)427-432
Number of pages6
JournalYonsei Medical Journal
Volume53
Issue number2
DOIs
Publication statusPublished - 2012 Mar 1

Fingerprint

Patient-Controlled Analgesia
Ketamine
Fentanyl
Pediatrics
Pain
Nausea
Ketorolac
Vomiting
Ondansetron
Hallucinations
Respiratory Insufficiency
Funnel Chest
Incidence
Pruritus
Double-Blind Method
Analgesics

Keywords

  • Fentanyl
  • Funnel chest
  • Ketamine
  • Patient-controlled analgesia
  • Pediatrics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Beneficial effects of adding ketamine to intravenous patient-controlled analgesia with fentanyl after the nuss procedure in pediatric patients. / Cha, Moon Ho; Eom, Ji Hye; Lee, Yoon Sook; Kim, Woon Young; Park, Young Cheol; Min, Sam Hong; Kim, Jae Hwan.

In: Yonsei Medical Journal, Vol. 53, No. 2, 01.03.2012, p. 427-432.

Research output: Contribution to journalArticle

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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 μg/kg/hr of fentanyl or 0.5 μg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 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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