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dc.contributor.authorBurstal Ren_US
dc.contributor.authorDanjoux Gen_US
dc.contributor.authorHayes Cen_US
dc.contributor.authorLantry Gen_US
dc.description.abstractFollowing a standardized general anaesthetic for total abdominal hysterectomy, patients received either patient controlled analgesia (PCA) with morphine 1 mg/ml (group M, n = 33) or morphine 1 mg/ml plus ketamine 2 mg/ml (group K, n = 37) for 48 hours in a randomized, double-blind fashion. In 43 women the area of allodynia around the scar was mapped as a measure of the degree of central sensitization. A significant reduction in the area of allodynia was found in those receiving ketamine with morphine (42 cm2 [interquartile range (IQR) 57] compared with 57 cm2 [IQR 82] z = -2.0, P = 0.04) in those receiving morphine alone. There were no significant differences between the two groups with respect to age, or weight, or between the subgroups within which the area of allodynia was measured with respect to length of incision. No significant differences were found between the groups with respect to pain scores, total or hourly drug consumption, patient satisfaction, nausea scores or antiemetic use. Patients in group K were more likely to require PCA for a shorter period than those in group M (median 40 hours, IQR 26 versus 48 hours IQR 7). Ten patients in group K were withdrawn because of side-effects (dysphoria n = 4, nausea n = 2, pruritus n = 4) compared with one in group M (nausea n = 1) (P = 0.006). The potential usefulness of ketamine after hysterectomy was offset by a high incidence of adverse effects and a lack of opioid-sparing effects, such that combined intravenous ketamine and morphine PCA as used in this study cannot be recommended for routine care.en_US
dc.subjectanalgesia, patient-controlleden_US
dc.subjectcentral nervous system sensitizationen_US
dc.subjectpatient satisfactionen_US
dc.subjectAnaesthesia, generalen_US
dc.titlePCA ketamine and morphine after abdominal hysterectomy.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAnaesthesia and intensive careen_US
dc.type.studyortrialClinical Trialen_US
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
Appears in Collections:Scholarly and Clinical
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