Results of a Double Blind Study on Small Doses of Ketamine for Postoperative Pain
Objective of the study: Pre- and postoperative small doses of ketamine, NMDA blocking agent (C13H16CINO-HCl) were included in perioperative pain control together with epidural local anesthetics and opioid administration, and effects on postoperative pain were compared. Patients and methods: 43 male...
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| Published in | Journal of Japan Society of Pain Clinicians Vol. 5; no. 2; pp. 125 - 133 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
Japan Society of Pain Clinicians
1998
一般社団法人 日本ペインクリニック学会 |
| Online Access | Get full text |
| ISSN | 1340-4903 1884-1791 |
| DOI | 10.11321/jjspc1994.5.125 |
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| Abstract | Objective of the study: Pre- and postoperative small doses of ketamine, NMDA blocking agent (C13H16CINO-HCl) were included in perioperative pain control together with epidural local anesthetics and opioid administration, and effects on postoperative pain were compared. Patients and methods: 43 male and female Japanese patients (30 upper abdomen and 13 lower abdomen) were divided into two groups, group 1 (23 patients; 61.7±7.8 years old) received ketamine 10mg given preoperatively and 25mg/day for 3 days postoperatively and group 2 (20 patients; 56.5±9.5 years old) given a placebo (saline). Subjects in the two groups' were selected in a double blind manner, and all procedures were approved by the Local Ethics Committee. Epidural analgesia plus general anesthesia (N2O+O2) were administered. In the recovery room, both groups of patients were given epidural bolus of buprenorphine 0.2mg, and epidural infusion of 0.25% bupivacaine 144ml+buprenorphine 0.6mg was given continuously for 3 days. At 6, 12, 24, 36, 48, 72 hours after surgery, the intensity of pain was evaluated using the Visual Analogue Scale (VAS). The required frequency of analgesics was also recorded to aid an evaluation of control of postoperative pain. Results: VAS values at rest and with physical movements in group 1 were significantly lower than those of group 2. The Mann-Whitney U-test was used to compare group 1 with group 2. Group 1 required smaller amounts of analgesics than did group 2. For events recorded 2 weeks after surgery, the untoward effects of ketamine were nil. Conclusion: In a double blind, randomized study, small doses of ketamine which did not produce frank anesthesia, led to control of postoperative pain, especially, pain related to physical movement. These findings strongly suggest that pre- and postoperative ketamine given in small doses pre- and postoperatively attenuate the hyperalgesia and allodynia caused by sensitization of NMDA receptors in the dorsal horn. |
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| AbstractList | Objective of the study: Pre- and postoperative small doses of ketamine, NMDA blocking agent (C13H16CINO-HCl) were included in perioperative pain control together with epidural local anesthetics and opioid administration, and effects on postoperative pain were compared. Patients and methods: 43 male and female Japanese patients (30 upper abdomen and 13 lower abdomen) were divided into two groups, group 1 (23 patients; 61.7±7.8 years old) received ketamine 10mg given preoperatively and 25mg/day for 3 days postoperatively and group 2 (20 patients; 56.5±9.5 years old) given a placebo (saline). Subjects in the two groups' were selected in a double blind manner, and all procedures were approved by the Local Ethics Committee. Epidural analgesia plus general anesthesia (N2O+O2) were administered. In the recovery room, both groups of patients were given epidural bolus of buprenorphine 0.2mg, and epidural infusion of 0.25% bupivacaine 144ml+buprenorphine 0.6mg was given continuously for 3 days. At 6, 12, 24, 36, 48, 72 hours after surgery, the intensity of pain was evaluated using the Visual Analogue Scale (VAS). The required frequency of analgesics was also recorded to aid an evaluation of control of postoperative pain. Results: VAS values at rest and with physical movements in group 1 were significantly lower than those of group 2. The Mann-Whitney U-test was used to compare group 1 with group 2. Group 1 required smaller amounts of analgesics than did group 2. For events recorded 2 weeks after surgery, the untoward effects of ketamine were nil. Conclusion: In a double blind, randomized study, small doses of ketamine which did not produce frank anesthesia, led to control of postoperative pain, especially, pain related to physical movement. These findings strongly suggest that pre- and postoperative ketamine given in small doses pre- and postoperatively attenuate the hyperalgesia and allodynia caused by sensitization of NMDA receptors in the dorsal horn. Objective of the study: Pre- and postoperative small doses of ketamine, NMDA blocking agent (C13H16CINO-HCl) were included in perioperative pain control together with epidural local anesthetics and opioid administration, and effects on postoperative pain were compared.Patients and methods: 43 male and female Japanese patients (30 upper abdomen and 13 lower abdomen) were divided into two groups, group 1 (23 patients; 61.7±7.8 years old) received ketamine 10mg given preoperatively and 25mg/day for 3 days postoperatively and group 2 (20 patients; 56.5±9.5 years old) given a placebo (saline). Subjects in the two groups' were selected in a double blind manner, and all procedures were approved by the Local Ethics Committee. Epidural analgesia plus general anesthesia (N2O+O2) were administered. In the recovery room, both groups of patients were given epidural bolus of buprenorphine 0.2mg, and epidural infusion of 0.25% bupivacaine 144ml+buprenorphine 0.6mg was given continuously for 3 days. At 6, 12, 24, 36, 48, 72 hours after surgery, the intensity of pain was evaluated using the Visual Analogue Scale (VAS). The required frequency of analgesics was also recorded to aid an evaluation of control of postoperative pain.Results: VAS values at rest and with physical movements in group 1 were significantly lower than those of group 2. The Mann-Whitney U-test was used to compare group 1 with group 2. Group 1 required smaller amounts of analgesics than did group 2. For events recorded 2 weeks after surgery, the untoward effects of ketamine were nil.Conclusion: In a double blind, randomized study, small doses of ketamine which did not produce frank anesthesia, led to control of postoperative pain, especially, pain related to physical movement. These findings strongly suggest that pre- and postoperative ketamine given in small doses pre- and postoperatively attenuate the hyperalgesia and allodynia caused by sensitization of NMDA receptors in the dorsal horn. 目的: 従来われわれは開腹術において, 術直前からの硬膜外ブロックと術後の持続硬膜外ブロックで求心性入力遮断を行なうことにより術後鎮痛を実施してきた. この方法にケタミンを術前術後に少量加えて中枢感作の抑制も考慮に入れた方法により術後痛にどのような改善効果が現われるか観察した. 対象と方法: 開腹手術を受けた患者43例を二重盲検法により第1群と第2群に分けた. 第1群は術前術後にケタミンを投与したケタミン群 (23例), 第2群は第1群のケタミンと同容量の生食を投与した生食群 (20例) とした. 硬膜外カテーテル挿入後, 両群とも気管内挿管による酸素-笑気併用の全身麻酔を行ない, 挿管直後にケタミン群はケタミン10mg, 生食群は同容量の生食を静注した. 回復室では両群ともブプレノルフィン0.2mg硬膜外投与した後, 0.25%ブピバカイン144ml+ブプレノルフィン0.6mgにケタミン群はケタミン75mgを加えたものを, 生食群はケタミンと同容量の生食を加えたものを3日間持続硬膜外投与した. 術後6, 12, 24, 36, 48, 72時間の安静および体動時の Visual Analogue Scale (VAS), 術後鎮痛剤使用回数, 副作用について観察した. 結果: 安静時および体動時のいずれにおいてもケタミン群は術後痛の程度が軽く推移した. しかも体動時にその効果が著明であった. また, 術後鎮痛剤の使用回数もケタミン群が少なく, ケタミンによると思われる副作用は特に認めなかった. 結論: 術前から術後にかけての局麻薬および局麻薬+ブプレノルフィンを用いた硬膜外ブロックによる求心性入力遮断に加え, 術前術後麻酔作用を起こさない少量ケタミンの投与により術後痛が軽減された. この鎮痛作用は投与量からケタミンの直接麻酔作用というよりNMDA受容体遮断効果による中枢感作の抑制によるものと考えられた. |
| Author | DAN, Kenjiro GOTOH, Hiroto MATSUNAGA, Matsuko |
| Author_FL | 松永 万鶴子 後藤 広人 檀 健二郎 |
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| DocumentTitle_FL | 二重盲検法による少量ケタミンの術前静注および術後硬膜外投与の術後鎮痛に及ぼす影響 |
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| References | 26) Ilkjaer S, Petersen KL, Brennum J, et al: Effect of systemic N-methyl-D-aspartate receptor antagonist (ketamine) on primary and secondary hyperalgesia in humans. Br J Anaesth 76: 829-834, 1996 9) Goudas LC, Carr DB: Postoperative pain control: a survey of promising drugs and pharmacoeconomic criteria for purchasing them. Pain 1996-an updated review refresher course syllabus, Campbell JN (ed), IASP press, Seattle, 1996, 189-193 60) Brock-Utne JG, Kallichurum S, Mankowitz E, et al: Intrathecal ketamine with preservative-histological effects on spinal nerve roots o f baboons. S Afr Med J 20: 440-441, 1982 58) Malinovsky JM, Cozian A, Lepage JY, et al: Ketamine and midazolam neurotoxicity in the rabbit. Anesthesiology 75: 91-97, 1991 31) Ravat F, Dorne R, Baechle JP, et al: Epidural ketamine or morphine for postoperative analgesia. Anesthesiology 66: 819-822, 1987 48) Grant IS, Nimmo WS, Clements JA: Pharmacokinetics and analgesic effects of i.m. and oral ketamine, Br J Anaesth 53: 805-810, 1981 11) Woolf CJ, Thompson SWN: The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation: implications for the treatment of post-injury pain hypersensitivity states. Pain 44: 293-299, 1991 23) Bhattacharya A, Gurnani A, Sharma PK, et al Subcutaneous infusion of ketamine and morphine for relief of postoperative pain: a double-blind comparative study. Ann Acad Med Singapore 23: 456-459, 1994 42) 其田一, 表圭一: 塩酸ケタミンの鎮痛機序に関する研究. 麻酔45: 689-697, 1996 56) Kallar SK: New modalities in postoperative nausea and vomiting. J Clin Anesth 4: 16-19, 1992 50) Tverskoy M, Oren M, Vaskovich M, et al: Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanism: a study in postoperative patients. Neurosci Lett 215: 5-8, 1996 7) 平良豊: 脊髄での侵害刺激の修飾. 日臨麻会誌17: 357-365, 1997 20) Fu ES, Miguel R, Scharf JE: Preemptive ketamine decreases postoperative narcotic requirements in patients undergoing abdominal surgery. Anesth Analg 84: 1086-1090, 1997 36) Wong CS, Liaw WJ, Tung CS, et al: Ketamine potentiates analgesic effect of morphine in postoperative epidural pain control. Reg Anesth 21: 534-541, 1996 2) 表圭一, 並木昭義: 術後痛とは. ペインクリニック18: 12-19, 1997 21) Roytblat L, Korotkoruchko A, Katz J, et al Postoperative pain: the effect of low-dose ketamine in a addition to general anesthesia. Anesth Analg 77: 1161-1165, 1993 3) Woolf CJ: Excitability changes in central neurons following peripheral damage: role of central sensitization in the pathogenesis of pain, Hyperalgesia and Allodynia, Willis WD Jr (ed), Raven press, New York, 1992, 221-243 1) Cousins M: Acute and postoperative pain, Textbook of Pain, 3rd ed, Wall PD, Melzack R (ed), Churchill-Livingstone, Philadelphia, 1995, 357-385 8) 小澤瀞司: NMDAレセプター. 臨麻18: 1697-1707, 1994 19) Barbieri M, Colnaghi E, Tommasino C, et al: Efficacy of the NMDA antagonist ketamine in preemptive analgesia, Proceedings of the 8th world congress on pain, progress in pain research and management, Jensen TS, Turner JA, Wiesenfeld-Hallin Z (ed), IASP press, Seattle, 1997, 343-349 40) Finck AD, Ngai SH: Opiate receptor mediation of ketamine analgesia. Anesthesiology 56: 291-297, 1982 33) Yamamoto T, Yaksh TL: Spinal pharmacology of thermal hyperesthesia induced by constriction injury of sciatic nerve: excitatory amino acid antagonists. Pain 49: 121-128, 1992 4) Niv D: Intraoperative treatment of postoperative pain, PAIN 1996-an updated review refresher course syllabus, Campbell JN (ed), IASP press, Seattle, 1996, 173-187 34) Yang CY, Wong CS, Chang JY, et al: Intrathecal ketamine reduces morphine requirements in patients with terminal cancer pain. Can J Anaesth 43: 379-383, 1996 49) Naguib M, Sharif AMY, Seraj M, et al: Ketamine for caudal analgesia in children: comparison with caudal bupivacaine. Br J Anaesth 67: 559-564, 1991 16) 松永万鶴子, 赤司和彦, 檀健二郎: 上腹部手術における術中硬膜外ブロックの術後鎮痛効果. ペインクリニック18: 47-53, 1997 18) Naguib M, Adu-Gyamfi Y, Absood GH, et al: Epidural ketamine for postoperative analgesia. Can Anaesth Soc J 33: 16-21, 1986 51) Edwards ND, Fletcher A, Cole JR, et al: Combined infusions of morphine and ketamine for postoperative pain in elderly patients. Anaesthesia 48: 124-127, 1993 28) Islas J-A, Astorga J, Laredo M: Epidural ketamine for control of postoperative pain. Aneth Analg 64: 1161-1162, 1985 22) Dich-Nielsen JO, Svendsen LB, Berthelsen P: Intramuscular low-dose ketamine versus pethidine for postoperative pain treatment after thoracic surgery. Acta Anaesth Scand 36: 583-587, 1992 32) Chung SK, Chan KH, Lee TY, et al: Epidural ketamine for postoperative pain relief. Anesth Sinica 24: 251-257, 1986 39) Smith DJ, Pekoe GM, Martin LL, et al: The interaction of ketamine with the opiate receptor. Life Sci 26: 789-795, 1980 35) Javery KB, Ussery TW, Steger HG, et al: Comparison of morphine and morphine with ketamine for postoperative analgesia. Can J Anaesth 43: 212-215, 1996 27) Warncke T, Stubhaug A, Jorum E: Ketamine, an NMDA receptor antagonist, suppresses spatial and temporal properties of burn-induced secondary hyperalgesia in man: a double-blind, cross-over comparison with morphine and placebo. Pain 72: 99-106, 1997 46) Kitahata LM, Taub A, Kosaka Y: Lamina-specific suppression of dorsal horn unit activity by ketamine hydrochloride. Anesthesiology 38: 4-11, 1973 57) Borgbjerg FM, Svensson BA, Frigast C, et al Histopathology after repeated intrathecal injections of preservative-free ketamine in the rabbit: a light and electron microscopic examination. Anesth Analg 79: 105-111, 1994 61) Brock-Utne JG, Mankowitz E, Kallichurum S, et al: Effects of intrathecal saline and ketamine with and without preservative on the spinal nerve roots of monkeys. S Afr Med J 6: 360-361, 1982 6) Woolf CJ, Chong M-S: Preemptive analgesia-treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 77: 362-379, 1993 43) Omote K, Namiki A: Ketamine update: recent research on anesthetic and analgesic action. Anesth Resus 30: 61-66, 1994 38) Malmberg AB, Yaksh TL: Voltage-sensitive calcium channels in spinal nociceptive processing: blockade of N- and P-type channels inhibits formaline-induced nociception. J Neurosci 14: 4882-4890, 1994 29) Kawano Y, Sato H, Shimada H, et al: Epidural ketamine for postoperative pain relief after gynecologic operations: a double-blind study and comparison with epidural morphine. Aneth Analg 66: 735-738, 1987 44) Tomemori N, Komatsu T, Shingu K, et al: Activation of the supraspinal pain inhibition system by ketamine hydrochloride. Act Anaesth Scand 25: 355-359, 1981 45) Iida H, Dohi S, Tanahashi T, et al: Spinal conduction block by intrathecal ketamine in dogs. Anesth Analg 85: 106-110, 1997 13) Ren K: Wind-up and the NMDA receptor: from animal studies to humans. Pain 59: 157-158, 1994 54) Kato Y, Homma I, Ichiyanagi K: Postherpetic neuralgia. Clin J Pain 11: 336-338, 1995 12) Kristensen JD, Svensson B, Gordh T Jr: The NMDA-receptor antagonist CPP abolishes neurogenic windup pain after intrathecal administration in hum ans. Pain 51: 249-253, 1992 25) Stubhaug A, Breivik H, Eid PK, et al: Ketamine reduces postoperative hyperalgesia, Proceeding of the 8th world congress on pain, progress in pain research and management, Jensen TS, Turner JA, Wiesenfeld-Hallin Z (ed), IASP press, Seattle, 1997, 333-342 41) Bansinath M, Warner W, Tang K, et al: On the mechanism of the interaction of ketamine and halothane in vitro. Gen Pharmac 23: 1183-1187, 1992 15) 松永万鶴子, 赤司和彦, 菅野博子, 他: 開腹及び腹腔鏡下胆嚢摘出術と胃切除術における術中硬膜外麻酔と術後鎮痛効果. 麻と蘇32: 257-261, 1996 37) Wong BS, Martin CD: Ketamine inhibition of cytoplasmic calcium signalling in rat pheochromocytom a (PC-12) cells. Life Sci 53: 359-364, 1993 24) Clausen L, Sinclair DM, Van Hasselt CH, et al Intravenous ketamine for postoperative analgesia. S Afr Med J 16: 1437-1440, 1975 53) Eide PK, Jørum E, Stubhaug A, et al: Relief of post-herpetic neuralgia with the N-methyl-D-aspartic acid receptor antagonist ketamine: a double-blind, cross-over comparison with morphine and placebo. Pain 58: 347-354, 1994 47) Owen H, Reekie RM, Clements JA, et al: Analgesia from morphine and ketamine a comparison of infusions of morphine and ketamine for postoperative analgesia. Anaesthesia 42: 1051-1056, 1987 62) Karpinski N, Dunn J, Hansen L, et al: Subpial vacuolar myelopathy after intrathecal ketamine: report of a case. Pain 73: 103-105, 1997 59) Malinovsky JM, Lepage JY, Cozian A, et al: Is ketamine or its preservative responsible for neurotoxicity in the rabbit? Anesthesiology 78: 109-115, 1993 30) Peat SJ, Bras P, Hanna MH: A double-blind comparison of epidural ketamine and diamorphine for postoperative pain. Anaesthesia 44: 555-558, 1989 17) 赤司和彦, 松永万鶴子, 比嘉和夫, 他: 腹腔鏡下胆嚢摘出術の麻酔法と術後鎮痛法の検討. 日ペインクリニック会誌3: 421-426, 1996 52) Arendt-Nielsen L, Nielsen J, Petersen-Felix S, et al: Effect of racemic mixture and the (S+)-isomer of ketamine on temporal and spatial summation of pain. Br J Anaesth 77: 625-631, 1996 5) Cousins MJ, Siddall PJ: Postoperative pain: implication of peripheral & central sensitization. 150years on, a selection of papers presented at the IInd World Congress of Anaesthesiolosists Keneally JP (ed), Bridge Priatery, New South Wales, 1996, 73-81 10) Barnard EA: Ionotropic glutamate receptors: new types and new concepts. Trends Pharmacol Sci 18: 141-148, 1997 14) Dickenson AH, Chapman V, Green GM: The pharmacology of excitatory and inhibitory amino acid-mediated events in the transmission and modulation of pain in the spinal cord. Gen Pharmac 28: 633-638, 1997 55) Camu F, Lauwers MH, Verbessem D: Incidence and aetiology of postoperative nausea and vomiting. Eur J Anaesth 9 (Suppl.): 25-31, 1992 |
| References_xml | – reference: 18) Naguib M, Adu-Gyamfi Y, Absood GH, et al: Epidural ketamine for postoperative analgesia. Can Anaesth Soc J 33: 16-21, 1986 – reference: 11) Woolf CJ, Thompson SWN: The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation: implications for the treatment of post-injury pain hypersensitivity states. Pain 44: 293-299, 1991 – reference: 4) Niv D: Intraoperative treatment of postoperative pain, PAIN 1996-an updated review refresher course syllabus, Campbell JN (ed), IASP press, Seattle, 1996, 173-187 – reference: 36) Wong CS, Liaw WJ, Tung CS, et al: Ketamine potentiates analgesic effect of morphine in postoperative epidural pain control. Reg Anesth 21: 534-541, 1996 – reference: 45) Iida H, Dohi S, Tanahashi T, et al: Spinal conduction block by intrathecal ketamine in dogs. Anesth Analg 85: 106-110, 1997 – reference: 3) Woolf CJ: Excitability changes in central neurons following peripheral damage: role of central sensitization in the pathogenesis of pain, Hyperalgesia and Allodynia, Willis WD Jr (ed), Raven press, New York, 1992, 221-243 – reference: 39) Smith DJ, Pekoe GM, Martin LL, et al: The interaction of ketamine with the opiate receptor. Life Sci 26: 789-795, 1980 – reference: 31) Ravat F, Dorne R, Baechle JP, et al: Epidural ketamine or morphine for postoperative analgesia. Anesthesiology 66: 819-822, 1987 – reference: 19) Barbieri M, Colnaghi E, Tommasino C, et al: Efficacy of the NMDA antagonist ketamine in preemptive analgesia, Proceedings of the 8th world congress on pain, progress in pain research and management, Jensen TS, Turner JA, Wiesenfeld-Hallin Z (ed), IASP press, Seattle, 1997, 343-349 – reference: 17) 赤司和彦, 松永万鶴子, 比嘉和夫, 他: 腹腔鏡下胆嚢摘出術の麻酔法と術後鎮痛法の検討. 日ペインクリニック会誌3: 421-426, 1996 – reference: 15) 松永万鶴子, 赤司和彦, 菅野博子, 他: 開腹及び腹腔鏡下胆嚢摘出術と胃切除術における術中硬膜外麻酔と術後鎮痛効果. 麻と蘇32: 257-261, 1996 – reference: 42) 其田一, 表圭一: 塩酸ケタミンの鎮痛機序に関する研究. 麻酔45: 689-697, 1996 – reference: 34) Yang CY, Wong CS, Chang JY, et al: Intrathecal ketamine reduces morphine requirements in patients with terminal cancer pain. Can J Anaesth 43: 379-383, 1996 – reference: 1) Cousins M: Acute and postoperative pain, Textbook of Pain, 3rd ed, Wall PD, Melzack R (ed), Churchill-Livingstone, Philadelphia, 1995, 357-385 – reference: 40) Finck AD, Ngai SH: Opiate receptor mediation of ketamine analgesia. Anesthesiology 56: 291-297, 1982 – reference: 24) Clausen L, Sinclair DM, Van Hasselt CH, et al Intravenous ketamine for postoperative analgesia. S Afr Med J 16: 1437-1440, 1975 – reference: 22) Dich-Nielsen JO, Svendsen LB, Berthelsen P: Intramuscular low-dose ketamine versus pethidine for postoperative pain treatment after thoracic surgery. Acta Anaesth Scand 36: 583-587, 1992 – reference: 50) Tverskoy M, Oren M, Vaskovich M, et al: Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanism: a study in postoperative patients. Neurosci Lett 215: 5-8, 1996 – reference: 52) Arendt-Nielsen L, Nielsen J, Petersen-Felix S, et al: Effect of racemic mixture and the (S+)-isomer of ketamine on temporal and spatial summation of pain. Br J Anaesth 77: 625-631, 1996 – reference: 62) Karpinski N, Dunn J, Hansen L, et al: Subpial vacuolar myelopathy after intrathecal ketamine: report of a case. Pain 73: 103-105, 1997 – reference: 10) Barnard EA: Ionotropic glutamate receptors: new types and new concepts. Trends Pharmacol Sci 18: 141-148, 1997 – reference: 29) Kawano Y, Sato H, Shimada H, et al: Epidural ketamine for postoperative pain relief after gynecologic operations: a double-blind study and comparison with epidural morphine. Aneth Analg 66: 735-738, 1987 – reference: 49) Naguib M, Sharif AMY, Seraj M, et al: Ketamine for caudal analgesia in children: comparison with caudal bupivacaine. Br J Anaesth 67: 559-564, 1991 – reference: 56) Kallar SK: New modalities in postoperative nausea and vomiting. J Clin Anesth 4: 16-19, 1992 – reference: 47) Owen H, Reekie RM, Clements JA, et al: Analgesia from morphine and ketamine a comparison of infusions of morphine and ketamine for postoperative analgesia. Anaesthesia 42: 1051-1056, 1987 – reference: 2) 表圭一, 並木昭義: 術後痛とは. ペインクリニック18: 12-19, 1997 – reference: 12) Kristensen JD, Svensson B, Gordh T Jr: The NMDA-receptor antagonist CPP abolishes neurogenic windup pain after intrathecal administration in hum ans. Pain 51: 249-253, 1992 – reference: 20) Fu ES, Miguel R, Scharf JE: Preemptive ketamine decreases postoperative narcotic requirements in patients undergoing abdominal surgery. Anesth Analg 84: 1086-1090, 1997 – reference: 37) Wong BS, Martin CD: Ketamine inhibition of cytoplasmic calcium signalling in rat pheochromocytom a (PC-12) cells. Life Sci 53: 359-364, 1993 – reference: 6) Woolf CJ, Chong M-S: Preemptive analgesia-treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 77: 362-379, 1993 – reference: 27) Warncke T, Stubhaug A, Jorum E: Ketamine, an NMDA receptor antagonist, suppresses spatial and temporal properties of burn-induced secondary hyperalgesia in man: a double-blind, cross-over comparison with morphine and placebo. Pain 72: 99-106, 1997 – reference: 48) Grant IS, Nimmo WS, Clements JA: Pharmacokinetics and analgesic effects of i.m. and oral ketamine, Br J Anaesth 53: 805-810, 1981 – reference: 59) Malinovsky JM, Lepage JY, Cozian A, et al: Is ketamine or its preservative responsible for neurotoxicity in the rabbit? Anesthesiology 78: 109-115, 1993 – reference: 61) Brock-Utne JG, Mankowitz E, Kallichurum S, et al: Effects of intrathecal saline and ketamine with and without preservative on the spinal nerve roots of monkeys. S Afr Med J 6: 360-361, 1982 – reference: 25) Stubhaug A, Breivik H, Eid PK, et al: Ketamine reduces postoperative hyperalgesia, Proceeding of the 8th world congress on pain, progress in pain research and management, Jensen TS, Turner JA, Wiesenfeld-Hallin Z (ed), IASP press, Seattle, 1997, 333-342 – reference: 30) Peat SJ, Bras P, Hanna MH: A double-blind comparison of epidural ketamine and diamorphine for postoperative pain. Anaesthesia 44: 555-558, 1989 – reference: 28) Islas J-A, Astorga J, Laredo M: Epidural ketamine for control of postoperative pain. Aneth Analg 64: 1161-1162, 1985 – reference: 58) Malinovsky JM, Cozian A, Lepage JY, et al: Ketamine and midazolam neurotoxicity in the rabbit. Anesthesiology 75: 91-97, 1991 – reference: 60) Brock-Utne JG, Kallichurum S, Mankowitz E, et al: Intrathecal ketamine with preservative-histological effects on spinal nerve roots o f baboons. S Afr Med J 20: 440-441, 1982 – reference: 33) Yamamoto T, Yaksh TL: Spinal pharmacology of thermal hyperesthesia induced by constriction injury of sciatic nerve: excitatory amino acid antagonists. Pain 49: 121-128, 1992 – reference: 38) Malmberg AB, Yaksh TL: Voltage-sensitive calcium channels in spinal nociceptive processing: blockade of N- and P-type channels inhibits formaline-induced nociception. J Neurosci 14: 4882-4890, 1994 – reference: 53) Eide PK, Jørum E, Stubhaug A, et al: Relief of post-herpetic neuralgia with the N-methyl-D-aspartic acid receptor antagonist ketamine: a double-blind, cross-over comparison with morphine and placebo. Pain 58: 347-354, 1994 – reference: 9) Goudas LC, Carr DB: Postoperative pain control: a survey of promising drugs and pharmacoeconomic criteria for purchasing them. Pain 1996-an updated review refresher course syllabus, Campbell JN (ed), IASP press, Seattle, 1996, 189-193 – reference: 23) Bhattacharya A, Gurnani A, Sharma PK, et al Subcutaneous infusion of ketamine and morphine for relief of postoperative pain: a double-blind comparative study. Ann Acad Med Singapore 23: 456-459, 1994 – reference: 35) Javery KB, Ussery TW, Steger HG, et al: Comparison of morphine and morphine with ketamine for postoperative analgesia. Can J Anaesth 43: 212-215, 1996 – reference: 32) Chung SK, Chan KH, Lee TY, et al: Epidural ketamine for postoperative pain relief. Anesth Sinica 24: 251-257, 1986 – reference: 7) 平良豊: 脊髄での侵害刺激の修飾. 日臨麻会誌17: 357-365, 1997 – reference: 43) Omote K, Namiki A: Ketamine update: recent research on anesthetic and analgesic action. Anesth Resus 30: 61-66, 1994 – reference: 51) Edwards ND, Fletcher A, Cole JR, et al: Combined infusions of morphine and ketamine for postoperative pain in elderly patients. Anaesthesia 48: 124-127, 1993 – reference: 5) Cousins MJ, Siddall PJ: Postoperative pain: implication of peripheral & central sensitization. 150years on, a selection of papers presented at the IInd World Congress of Anaesthesiolosists Keneally JP (ed), Bridge Priatery, New South Wales, 1996, 73-81 – reference: 26) Ilkjaer S, Petersen KL, Brennum J, et al: Effect of systemic N-methyl-D-aspartate receptor antagonist (ketamine) on primary and secondary hyperalgesia in humans. Br J Anaesth 76: 829-834, 1996 – reference: 21) Roytblat L, Korotkoruchko A, Katz J, et al Postoperative pain: the effect of low-dose ketamine in a addition to general anesthesia. Anesth Analg 77: 1161-1165, 1993 – reference: 14) Dickenson AH, Chapman V, Green GM: The pharmacology of excitatory and inhibitory amino acid-mediated events in the transmission and modulation of pain in the spinal cord. Gen Pharmac 28: 633-638, 1997 – reference: 57) Borgbjerg FM, Svensson BA, Frigast C, et al Histopathology after repeated intrathecal injections of preservative-free ketamine in the rabbit: a light and electron microscopic examination. Anesth Analg 79: 105-111, 1994 – reference: 13) Ren K: Wind-up and the NMDA receptor: from animal studies to humans. Pain 59: 157-158, 1994 – reference: 46) Kitahata LM, Taub A, Kosaka Y: Lamina-specific suppression of dorsal horn unit activity by ketamine hydrochloride. Anesthesiology 38: 4-11, 1973 – reference: 41) Bansinath M, Warner W, Tang K, et al: On the mechanism of the interaction of ketamine and halothane in vitro. Gen Pharmac 23: 1183-1187, 1992 – reference: 55) Camu F, Lauwers MH, Verbessem D: Incidence and aetiology of postoperative nausea and vomiting. Eur J Anaesth 9 (Suppl.): 25-31, 1992 – reference: 44) Tomemori N, Komatsu T, Shingu K, et al: Activation of the supraspinal pain inhibition system by ketamine hydrochloride. Act Anaesth Scand 25: 355-359, 1981 – reference: 54) Kato Y, Homma I, Ichiyanagi K: Postherpetic neuralgia. Clin J Pain 11: 336-338, 1995 – reference: 8) 小澤瀞司: NMDAレセプター. 臨麻18: 1697-1707, 1994 – reference: 16) 松永万鶴子, 赤司和彦, 檀健二郎: 上腹部手術における術中硬膜外ブロックの術後鎮痛効果. ペインクリニック18: 47-53, 1997 |
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| Title | Results of a Double Blind Study on Small Doses of Ketamine for Postoperative Pain |
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