Addition of Ketamine to Propofol-Alfentanil Anesthesia May Reduce Postoperative Pain in Laparoscopic Cholecystectomy

Abstract

The aim of this study was to assess whether intravenous anesthesia supplemented with ketamine reduces postoperative pain after elective laparoscopic cholecystectomy. Forty patients were enrolled and randomized 1:1 into one of 2 groups: the propofol group (received propofol and alfentanil supplemented with saline) and the ketamine group (received propofol and alfentanil with ketamine). The study was double-blind. The number and amount of the intraoperative additional alfentanil doses were recorded. Pain assessments and cumulative analgesic consumption at postanesthesia care unit (PACU) admission, PACU discharge, postoperative 24th hour, and hospital discharge were recorded. The visual analog scale scores at PACU admission, PACU discharge, postoperative 24th hour, and hospital discharge were significantly lower in the ketamine group than the propofol group. The pain visual analog scale ≥ 75 at the postoperative 24th hour for the propofol group was also significantly lower (P<0.035) than that of the ketamine group. The difference in analgesic consumption between groups was statistically significant (P<0.001). Our study showed that ketamine supplemented with propofol and alfentanil produced better analgesia intraoperatively and postoperatively and decreased analgesic consumption compared with the propofol group after laparoscopic cholecystectomy.