Prophylactic Analgesic Effect of Adding Ketamine to Bupivacaine in Lumbar Fusion Surgery: A Randomized Controlled Trial

Authors

  • Azim Honarmand Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Mehdi Mahmoodkhani Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Behzad Nazemroaya Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Alireza Ahmadian Department of Anesthesiology and Critical Care,School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

DOI:

https://doi.org/10.18502/aacc.v12i5.22430

Keywords:

Ketamine; Bupivacaine; Lumbar fusion; Postoperative pain

Abstract

Background: This randomized controlled trial evaluated the analgesic effect of adding subcutaneous ketamine to bupivacaine in lumbar fusion surgery.

Methods: 46 adult patients were randomized to receive subcutaneous bupivacaine with or without ketamine before incision. Pain scores (VAS), time to first rescue analgesia, opioid use, extubation time, and patient satisfaction were assessed.

Results: The ketamine group had higher early postoperative pain (30 and 60 min; P < 0.05) but showed prolonged time to rescue analgesia (P = 0.037) and reduced opioid use (not statistically significant). Extubation time was significantly longer. Satisfaction scores were similar.

Conclusion: Subcutaneous ketamine delayed opioid use but increased early pain and extubation time. It may be considered in selected patients, pending further research

Published

2026-08-26

Issue

Volume (12) issue (5)

Section

Articles