The Effect of Preprocedural Low-Dose Ketamine for Pain and Anxiety in Patients during Thoracic Epidural Catheterization.
Onur Küçük, Esra Sarı, Musa Zengin, Gülay Ülger, Fatma Öztürk Yalçın, Ramazan Baldemir, Mehtap Tunç, Ali Alagöz
Medicina (Kaunas, Lithuania) April 22, 2024 DOI: 10.3390/medicina60040679 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 60 |
| Population | Patients undergoing awake thoracic epidural catheterization |
| Intervention | Ketamine |
| Dose | 0.15 mg/kg |
| Topics | Anxiety Ketamine Esketamine |
| Keywords | Preprocedural low dose Thoracic epidural catheterization Pain management Anesthesia Procedural anxiety Spinal procedures Patient comfort |
| Citations | 2 |
| Key findings | Preprocedural low-dose ketamine (0.15 mg/kg) significantly reduced pain and anxiety during thoracic epidural catheterization compared to placebo. |
Abstract
Background and
Objectives: Thoracic epidural catheterization (TEC) can be both uncomfortable and fearful for patients when performed awake with the thought that the procedure may be painful. The aim of this study was to assess the effect of low-dose intravenous ketamine administration on pain and anxiety during the TEC procedure.
Materials and Methods: Sixty patients were randomly divided into two groups to receive intravenous (IV) placebo (Group P) and IV low-dose (0.15 mg/kg) ketamine (LDK) (Group K) 3 min before the procedure in a double-blind manner. A visual analog scale (VAS) was used to measure anxiety (VAS-A) and pain (VAS-P) scores. Vital parameters were monitored before premedication (T1), 20 min after premedication (T2), during skin anesthesia (T3), during TEC (T4), and 5 min after TEC (T5). VAS-A values were recorded at T1, T3, T4, and T5 periods, and VAS-P levels were noted at T3, T4, and T5 periods.
Results: During TEC (T4), both VAS-P and VAS-A were significantly lower in Group K (p < 0.001). The mean VAS-A value was 10.6 mm lower, and the mean VAS-P value was 9 mm lower in Group K than in Group P at the T4 time point. Additionally, the mean VAS-P value was 7.7 mm lower in Group K compared to Group P at the T3 time point (p < 0.001). Both groups showed a statistically significant difference in VAS-A measurements when compared at their respective time points (p < 0.001). However, only Group P demonstrated a statistically significant difference in VAS-P measurements (p < 0.001). VAS-P values remained stable in Group K. The number of patients who did not recall the procedure was significantly higher in Group K (p < 0.001). Furthermore, the number of patients who would consent to the same procedure in the future was significantly higher in Group K (p = 0.007).
Conclusions: A preprocedural LDK (0.15 mg/kg) can effectively prevent anxiety and pain experienced by patients during the TEC procedure. Administration of LDK may provide a more comfortable procedure process without causing ketamine-induced side effects (hemodynamic, respiratory, and psychological).
Comparable studies
Other randomized controlled trials on ketamine for anxiety, most cited first.