alexa Transdermal Ketamine and S(+)-Ketamine as Adjuvants Following Orthopaedic Surgery under Bupivacaine Spinal Anaesthesia
ISSN: 2161-0398

Journal of Physical Chemistry & Biophysics
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Research Article

Transdermal Ketamine and S(+)-Ketamine as Adjuvants Following Orthopaedic Surgery under Bupivacaine Spinal Anaesthesia

Gabriela Rocha Lauretti1*, Marcia Amaral2, Ramon Dangelo Dias3, Vera Lucia Lanchote4 and Anita Leocádia de Mattos5
1School of Medicine of Ribeirão Preto- University of São Paulo, Brazil
2Consultant in Anesthesiology, São Francisco Hospital, Brazil
3Resident in Anesthesiology, School of Medicine of Ribeirão Preto- University of São Paulo, Brazil
4Faculty of Pharmaceutical Sciences of Ribeirão Preto- University of São Paulo, Brazil
5Assistant Professor of Anesthesiology and Pain Management, School of Medicine of Ribeirão Preto- University of São Paulo, Brazil
Corresponding Author : Gabriela Rocha Lauretti
Rua Maestro Joaquim Rangel, 644
Ribeirão Preto, São Paulo, Brazil-14025-610
Tel/Fax: 55(16) 3602 2211
E-mail: [email protected]
Received July 08, 2014; Accepted August 18, 2014; Published August 20, 2014
Citation: Lauretti GR, Amaral M, Dias RD, Lanchote VL, Mattos AL (2014) Transdermal Ketamine and S(+)-Ketamine as Adjuvants Following Orthopaedic Surgery under Bupivacaine Spinal Anaesthesia. J Phys Chem Biophys 4:154. doi:10.4172/2161-0398.1000154
Copyright: © 2014 Lauretti GR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

The aim of the study was to examine the perioperative analgesic effect of topical deliver of either ketamine or S(+)- ketamine in orthopaedic postoperative pain through clinical and laboratorial evaluation. 45 patients following minor orthopaedic surgery were randomized to one of three groups (n=15). Spinal anaesthesia was performed with 15 mg hyperbaric bupivacaine. Twenty min after the spinal puncture, a controlled delivery topical cream containing either 25 mg ketamine (KG), 25 mg S(+)-ketamine (+KG) or placebo (PG) was applied. Pain and adverse effects were assessed postoperatively for 24 h. Intravenous ketoprofen was available at patient request. The plasmatic concentration of ketamine and S(+)-ketamine was measured prior the spinal puncture, 30 min, 4-hour, 8-hour, 16-hour and 24-hour after topical application by High Performance Liquid Chromatography (HPLC). Time to first rescue analgesic was longer to both KG and +KG (10 hours) compared to the PG (5 hours); (p<0.05). Ketoprofen consumption (mg) in 24 hour was higher in the PG compared to the others (p<0.0005). Thirty-min after the transdermal application, ketamine and S(+)-ketamine were detectable in plasma in both KG and +KG by HPLC, and showed a dose-ranging curve during the 24-hour evaluation (p<0.02). Adverse effects were similar among groups. As conclusions, transdermal 25 mg ketamine or 25 mg S(+)- ketamine similarly prolonged the duration of analgesia following orthopaedic procedures under bupivacaine spinal blockade, demonstrated by clinical and laboratorial data.

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