| The Efficacy of Epidural Ketamine on Shivering during Transurethral Resection of the Prostate under Epidural Anesthesia. |
|
| Dong Youp Han, Hee Jong Jeong, Cheol Lee, Deok Hwa Choi |
1Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Iksan, Korea.
2Department of Urology, Wonkwang University School of Medicine, Iksan, Korea. uro94c@wmc.ac.kr |
|
|
|
|
|
| ABSTRACT |
PURPOSE
Ketamine may decrease core-to-peripheral redistribution of heat through direct central sympathetic stimulation and inhibition of norepinephrine uptake into postganglionic sympathetic nerve endings. The purpose of this study was to evaluate the efficacy of epidural ketamine in preventing shivering during transurethral resection of the prostate (TURP) under epidural anesthesia.
MATERIALS AND METHODS
Ninety-three male patients scheduled for TURP under epidural anesthesia were enrolled in this study. Patients were randomized into one of three groups.
Group 1 consisted of 31 patients who received epidural 0.75% ropivacaine, group 2 consisted of 32 patients who received epidural ketamine (0.2 mg/kg) in addition to 0.75% ropivacaine, and group 3 consisted of 30 patients who received epidural ketamine (0.4 mg/kg) in addition to 0.75% ropivacaine. Shivering and side effects such as hypotension, bradycardia, nausea, and hallucination were recorded during the anesthesia and for 2 hours while in the postanesthetic recovery room.
RESULTS
Shivering was statistically more frequent in group 1 than in the other groups. The incidence of sedation was significantly higher in group 3 than in the other groups.
The incidences of side effects such as hypotension, bradycardia, and nausea were significantly higher in group 1 than in the other groups.
CONCLUSIONS
In this study, epidural ketamine 0.2 mg/kg and 0.4 mg/kg was shown to have a lower incidence of shivering and other side effects except sedation. In patients who undergo TURP under epidural anesthesia, the prophylactic use of low-dose epidural ketamine would be helpful in preventing any adverse effects, including shivering. |
| Keywords:
Epidural anesthesia; Ketamine; Shivering; Transurethral resection of prostate |
|
PDF Links
PPT Slide
Full text via DOI
Full text via PMC
