The use of oral ketamine in the management of posthemrroidectomy

Hemorrhoidectomy can be associated with severe pain in the immediate postoperative period. The aim of this study was to assess the efficacy of oral ketamine, in the reduction of pain and analgesic requirements after hemorrhoidectomy. 80 patients were suitable for an established day surgery hemorrhoidectomy protocol. Immediately before surgery patients were randomly assigned either to receive (Group 1) or not receive (Group 2) the oral ketamine. All other aspects of surgery and anesthesia were standardized. In the postoperative period, analgesia was maintained with IV pethedine. Pain was assessed by VAS (Visual analogue scale) at T0 (arousal), and T4, T12, T24 later. The interval time for the first request of analgesia and the total amount of analgesic consumption were reported. All statistical analyses were performed with SPSS. There was a statistical difference between the 2 groups in the average mean values of pain intensity at T0 and T4, T12, T24 in the numerical scale. The interval time to request the first analgesic supplement was longer in the G1 than G2 (7.5 hr versus 1.5 hr p <0.05). There was a statistical difference between G1 and G2 in the total dose of pethedine consumption (p <0.05). In this study, the use of oral ketamine, is associated with a significant decrease in pain and analgesia requirements after hemorrhoidectomy.