An intraoperative small dose of ketamine prevents remifentanil-induced postanesthetic shivering.
Author(s): Nakasuji M, Nakamura M, Imanaka N, Tanaka M, Nomura M, Suh SH
Affiliation(s): Department of Anesthesiology, Kansai Denryoku Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka 553-0003, Japan. email@example.com
Publication date & source: 2011-09, Anesth Analg., 113(3):484-7. Epub 2011 Aug 3.
Publication type: Randomized Controlled Trial
Patients undergoing gynecological laparotomy were randomized to receive either 0.5 mg/kg ketamine at induction of anesthesia followed by an infusion of 0.3 mg/kg/h until the end of surgery (ketamine group, n = 32), or an equivalent volume of normal saline (control group, n = 32). Anesthesia was maintained with IV propofol, a fixed infusion rate of remifentanil (0.25 mug/kg/min), and epidural ropivacaine. Postanesthetic shivering (PAS) was evaluated for 30 minutes after emergence. Intraoperative temperatures were similar between the 2 groups. The incidence of PAS was less frequent in the ketamine group (n = 2, 6%) compared with the control group (n = 12, 38%, P = 0.005). We conclude that, during the early recovery phase, intraoperative ketamine reduces remifentanil-induced PAS.