scholarly journals The effect of low dose ketamine on postoperative quality of recovery in patients undergoing breast cancer surgery: a randomized, placebo‐controlled trial

Author(s):  
Zi‐Jian Zhao ◽  
Qi‐Qi Xu ◽  
Yao Chen ◽  
Chen Liu ◽  
Fang‐Fang Zhang ◽  
...  
2019 ◽  
Author(s):  
Yuan Han ◽  
Zijian Zhao ◽  
Qiqi Xu ◽  
Yao Chen ◽  
Chen Liu ◽  
...  

Abstract Background: Intraoperative low dose ketamine has been widely studied for postoperative multimodal analgesia. However, the effect of low dose ketamine on postoperative quality of recovery in female patients undergoing breast cancer surgery has not been studied. The primary aim of this study was to assess the effects of low dose ketamine on postoperative quality of recovery in these patients using the 40-Item Quality of Recovery (QoR-40) scale. The second aim of this study was to evaluate the effects of intraoperative infusion of low-dose ketamine on chronic postoperative surgical pain (CPSP). Methods: In this prospective, randomized, double-blind trial, 100 patients planned for modified radial mastectomy were randomly assigned to one of two groups: control group (group C) and ketamine group (group K). After induction of anesthesia and before surgical incision, a bolus dose of 0.5 mg/kg ketamine or an equivalent volume of normal saline was injected followed by 0.25 mg/kg/h ketamine or normal saline infusions until skin closure. Postoperative recovery profiles, including the QoR-40 scores on postoperative day 1, numeric rating scale (NRS), and douleur neuropathique 4 (DN-4) questionnaire at postoperative month 3 were evaluated. In addition, patient characteristics, perioperative parameters, and safety outcomes were assessed. Results: Global QoR-40 scores on postoperative day 1 were not significantly different between both groups (p = 0.139). Of the five dimensions, emotional state and pain scores were significantly higher in group K than in group C (p = 0.044 and 0.023, respectively). At postoperative month 3, CPSP and neuropathic pain (NP) were not significantly different between groups (p = 0.259 and 0.959, respectively). The incidence of safety outcomes were similar between groups. Conclusion: Low dose ketamine did not improve overall quality of recovery or chronic pain in patients undergoing breast cancer surgery.


2011 ◽  
Vol 18 (9) ◽  
pp. 2477-2482 ◽  
Author(s):  
Jennifer F. Waljee ◽  
Peter A. Ubel ◽  
Dunya M. Atisha ◽  
Emily S. Hu ◽  
Amy K. Alderman

2018 ◽  
Vol 35 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Yoshinori Kamiya ◽  
Miki Hasegawa ◽  
Takayuki Yoshida ◽  
Misako Takamatsu ◽  
Yu Koyama

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3539-3547
Author(s):  
Zeng-Mao Lin ◽  
Mu-Han Li ◽  
Feng Zhang ◽  
Xue Li ◽  
Chun-Li Shao ◽  
...  

Abstract Objective To evaluate the effect of multilevel single-shot thoracic paravertebral blockade (PVB) on the occurrence of chronic postsurgical pain (CPSP) in patients undergoing breast cancer surgery. Design A randomized controlled trial with two parallel groups. Setting A tertiary hospital. Methods Patients scheduled for breast cancer surgery were randomized to receive either ultrasound-guided multilevel single-shot PVB from T2 to T5 (the PVB group) or nothing (the control group). Surgery was then performed under general anesthesia. Patients were followed up for 12 months after surgery. The primary end point was incidence of CPSP at six months after surgery. Results A total of 218 patients were enrolled and randomized; of these, 208 and 204 completed six- and 12-month follow-up, respectively. The incidence of CPSP at six months was significantly lower in the PVB group (12.5% [13/104]) than in the control group (24.0% [25/104], relative risk = 0.52, 95% CI = 0.28–0.96, P = 0.031). Pain scores within 48 hours both at rest and with movement were lower in the PVB group than the control group (P = 0.006 and P < 0.001, respectively). The percentages of patients with neuropathic pain were also lower in the PVB group than the control group at both six and 12 months after surgery (P = 0.016 and 0.028, respectively). Adverse events did not differ between groups. Conclusions For patients undergoing breast cancer surgery, multilevel single-shot PVB reduces the incidence of CPSP at six months; it also improves early postoperative analgesia and reduces neuropathic pain at six and 12 months after surgery.


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