%0 Journal Article
%T Effect of Ketamine Instillation on Acute and Chronic Post Mastectomy Pain, a Dose Finding Clinical Study
%A Fatma El Sherif
%A Hany Elmorabaa
%A Khaled Mohamed Fares
%A Sahar Abdel-Baky Mohamed
%A Nourhan M. Elgalaly
%A Khalid Rezk
%A Moaaz Tohamy
%J Open Journal of Anesthesiology
%P 146-159
%@ 2164-5558
%D 2022
%I Scientific Research Publishing
%R 10.4236/ojanes.2022.124013
%X <b>Background:</b> Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. <b>Objectives:</b> To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2, or 3 mg/kg) for acute and chronic post mastectomy pain (PMP). <b>Methods:</b> Ninety female patients with cancer breast, aged (18 - 60 yrs), weighted (50 - 90 kg), scheduled for modified radical mastectomy, randomly allocated into 3 groups to receive ketamine instillation after surgical homeostasis before wound closure (1 of 3 doses; 1, 2, or 3 mg/kg as A, B or C groups respectively) patients were followed up for 48 h for acute pain (total morphine consumption, the first request of analgesia and visual analog scale at rest and movement (VASR/M), chronic pain by Leeds assessment of neuropathic signs and symptoms (LANSS) for six-months, hemodynamics, and side effects. <b>Results:</b> Median total dose of morphine consumption was 8 mg (5 - 10) versus 6 mg (6 - 7) in A and B groups respectively in the first 48 h postoperatively. Lowest VASR/M was recorded in C then B and lastly A group (P = 0.037). No patients in the C group requested analgesia versus thirty (100%) and nine (30%) patients in the A and B groups respectively with the first request of analgesia was 12 h (5 - 36) in the A group versus 30 h (12 - 36) in the B group respectively (P < 0.001). In the three studied groups, no patients in the C group had neuropathic pain versus 2 and 9 patients in B and A groups respectively (P ¡Ü 0.001) without serious side effects. <b>Conclusion:</b> Ketamine instillation effectively controlled acute post mastectomy pain (PMP) in a dose-dependent manner and reduced the incidence and severity of chronic pain in patients who undergoing a modified radical mastectomy.
%K Acute Pain
%K Breast Cancer
%K Chronic Pain
%K Ketamine Instillation
%K Modified Radical Mastectomy
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=116593