Medical Journal of the Islamic Republic Of Iran

en Effects of Ketamine and Lidocaine Infusion on Acute Pain after Elective Open Abdominal Surgery, a Randomized, Double-Blinded Study Anesthesia Anesthesia Original Research Original Research Background: Most patients suffer from moderate to severe pain after elective laparotomy. They often require opioids to alleviate their pain. Opiates invariably induce certain side effects and, occasionally, dependence. Intraoperative infusion of lidocaine and low-dose ketamine reduces postoperative pain and analgesic requirements. This study aims to evaluate the effects of simultaneous infusion of lidocaine and ketamine during open abdominal surgery on the postoperative pain severity and analgesic consumption.    Methods: In this randomized, double-blinded, single-center study that was performed in Iran, 80 patients scheduled for elective open abdominal surgery under general anesthesia were enrolled in two LK and P groups. Group LK (n=40) received lidocaine-ketamine infusion, and group P (n=40) received placebo (normal saline). Both infusions were started thirty minutes after initiation of surgery and were terminated once the surgery was completed. For postoperative pain management, patient-controlled analgesia (PCA), including fentanyl and paracetamol, was administered for both groups. All patients were evaluated for pain visual analogue scale (VAS) and total adjunctive analgesic (diclofenac suppository) consumption within the first 24 hours after the surgery. The data were analyzed using SPSS. P values <0.05 were considered significant.    Results: Intraoperative infusion of Lidocaine and Ketamine resulted in desirable postoperative pain control. Patients of LK group demonstrated a significant reduction in the pain score at 1, 6, 12, 18, and 24 hours after termination of surgery (p<0.001). It also resulted in a decreased requirement for postoperative analgesics, as cumulative analgesic consumption was decreased meaningfully in the patients of LK group (p<0.001).    Conclusion: Intravenous infusion of lidocaine and ketamine during elective open abdominal surgery reduces pain intensity and analgesic requirements in the first 24 hours postoperatively, without major additional side effects. Ketamine, Lidocaine, Pain, Laparotomy 425 429 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-4149-2&slc_lang=en&sid=1 Farnad Imani imani.f@iums.ac.ir 200319475328460070773 200319475328460070773 Yes Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran Ali-reza Bagheri a.bagheri.iums@gmail.com 200319475328460070774 200319475328460070774 No Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran Esmat Arvin esmatarvin88@gmail.com 200319475328460070775 200319475328460070775 No Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Stephen P. Gatt gattsp@gmail.com 200319475328460070776 200319475328460070776 No Anestesi & Reanimasi, Udayana Universiti, Bali, Indonesia; Discipline of Anaesthesia, Critical Cate & Emergency Medicine, University New South Wales, Sydney, Australia Arash Sarveazad arashsarveazad@gmail.com 200319475328460070777 200319475328460070777 No Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran