Key result
Continuous low-dose ketamine infusion combined with PCA morphine provided excellent postoperative analgesia and early mobility, though an opioid-sparing effect was not demonstrated.
Why the study?
Does continuous low-dose intravenous ketamine infusion combined with PCA morphine improve postoperative analgesia in an adolescent girl undergoing posterior spinal instrumentation for scoliosis?
Case Report (n=1)
Does continuous low-dose intravenous ketamine infusion combined with PCA morphine improve postoperative analgesia in an adolescent girl undergoing posterior spinal instrumentation for scoliosis?
Continuous low-dose ketamine infusion combined with PCA morphine provided excellent postoperative analgesia and facilitated early rehabilitation in a patient undergoing scoliosis correction, though without demonstrating an opioid-sparing effect.
May support ketamine-morphine PCA for analgesia and mobility after scoliosis surgery; hypothesis-generating, requires RCTs before practice change.
Providing effective analgesia is challenging for correction of idiopathic scoliosis, as nonsteroidal anti-inflammatory drugs and epidural anesthesia are controversial and large-dose opioids can cause significant side effects. Perioperative adjuvant low-dose ketamine has been shown to provide good supplementary analgesia as well as to potentially spare opioid consumption. Ketamine may also improve early ease of mobility without addition of any noticeable adverse effects. This case describes the combined use of a continuous low-dose ketamine infusion and patient-controlled analgesia (PCA) morphine for postoperative analgesia in an adolescent girl undergoing posterior spinal instrumentation and correction of scoliosis. The patient had excellent postoperative analgesia and was able to participate in early rehabilitation. The opioid-sparing effect of ketamine was not demonstrated in this case. Further study of continuous low-dose ketamine infusions in this patient population would be beneficial to provide more evaluation of the efficacy and tolerability of ketamine and of its opioid-sparing potential.
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Tsui et al. (2006) conducted a case report in Idiopathic scoliosis (n=1). Continuous low-dose ketamine infusion and PCA morphine was evaluated on Postoperative analgesia and opioid-sparing effect. Continuous low-dose ketamine infusion combined with PCA morphine provided excellent postoperative analgesia and early mobility, though an opioid-sparing effect was not demonstrated.
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