Objectives: The administration of ketamine as nebulized inhalation is relatively new and studies
on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized
ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing
elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline
placebo.
Methods: One hundred children aged (7---12) years were randomly allocated in four groups
(n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg−1 (Group K-IV), Nebulized
Ketamine 1 mg.kg−1 (Group K-N1) or 2 mg.kg−1 (Group K-N2). The primary endpoint was
the total consumption of rescue analgesics in the first 24 h postoperative.
Results: The mean time to first request for rescue analgesics was prolonged in K-N1
(400.9
±
60.5 min, 95% CI 375.9---425.87) and K-N2 (455.5
±
44.6 min, 95% CI 437.1---473.9) groups
compared with Group K-IV (318.5
±
86.1 min, 95% CI 282.9---354.1) and Group C (68.3
±
21.9 min,
95% CI 59.5---77.1; p < 0.001), with a significant difference between K-N1 and K-N2 Groups
(p < 0.001). The total consumption of IV paracetamol in the first 24 h postoperative was reduced
in Group K-IV (672.6
±
272.8 mg, 95% CI 559.9---785.2), Group K-N1 (715.6
±
103.2 mg, 95% CI
590.4---840.8) and Group K-N2 (696.6
±
133.3 mg, 95% CI 558.8---834.4) compared with Control
Group (1153.8
±
312.4 mg, 95% CI 1024.8---1282.8; p < 0.001). With no difference between
intravenous and Nebulized Ketamine Groups (p = 0.312). Patients in intravenous and Nebulized
Ketamine Groups showed lower postoperative VRS scores compared with Group C (p < 0.001),
no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects.
Research Member
Research Department
Research Date
Research Year
2019
Research Journal
REVISTA BRASILEIRA DE ANESTESIOLOGIA
Research Publisher
Elsevier Editora Ltda
Research Vol
69
Research Rank
4
Research_Pages
350-357
Research File
Research Website
https://doi.org/10.1016/j.bjane.2019.04.005
Research Abstract