Ketamine Improves Post-Thoracotomy Analgesia
We planned a prospective, randomomized, double blind study of 2 pain management protocols in
consecutive patients undergoing thoracotomy for MIDCAB or lung tumor resection over a 6
month period. After patients emerged from a standardized general anesthetic and when
objectively awake and complaining of pain >5/10 on a visual analogue pain scale, they were
connected to an intravenous patient controlled analgesia regimen. The regimen was assigned
randomly to be either morphine alone (1.5 mg per dose, lockout interval of 7 minutes) or
morphine plus ketamine (1.0 mg morphine plus 5 mg ketamine per dose, same lockout interval).
Rescue diclofenac was available to both groups. Follow-up lasted 4 hours.
We planned to monitor and compare pain scores, wakefulness scores, hemodynamic and
respiratory parameters as well as total morphine consumption and incidence of side effects
and complications. All monitoring and recording was done by blinded nurses and intensive
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Avi A Weinbroum, MD
Tel-Aviv Sourasky Medical Center
Israel: Ministry of Health