The effects of anesthesia and surgery can lead to stress responses that result in hormonal and metabolic changes in the body. The immune system and the nervous system communicate both ways, and it was found that nociception and proinflammatory cytokines play a joint regulatory role, i.e., increased production of proinflammatory cytokines can worsen the pain. Major surgery can trigger the release of cytokines such as IL-1, IL-6, and TNF-α.
The effects of anesthesia and surgery can lead to stress responses that result in hormonal and metabolic changes in the body. The immune system and the nervous system communicate both ways, and it was found that nociception and proinflammatory cytokines play a joint regulatory role, i.e., increased production of proinflammatory cytokines can worsen the pain. Major surgery can trigger the release of cytokines such as IL-1, IL-6, and TNF-α. The acute analgesic effect of ketamine is generally believed to be mediated through the blockade of the phencyclidine binding site of the N-methyl-d-aspartate (NMDA) receptor of nociceptive neurons. Ketamine can reduce the inflammatory response marked by a decrease in CRP levels to surgical trauma and can prevent secondary damage to tissues/organs that were not initially affected by surgery by reducing inflammation. This also reduces postoperative pain and analgesics.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
68
Ketamine 0.3 mg/kg at end-of-surgery (intravenously)
Ketamine 0.3 mg/kg at anesthesia induction (intravenously)
Sanglah General Hospital
Denpasar, Bali, Indonesia
Serum CRP level
Serum C-reactive protein level
Time frame: 1-hour before surgery
Serum CRP level
Serum C-reactive protein level
Time frame: 24-hours after surgery
serum neutrophil-count
serum neutrophil-count (from a complete blood count test)
Time frame: 1-hour before surgery
serum neutrophil-count
serum neutrophil-count (from a complete blood count test)
Time frame: 24-hours after surgery
VAS (visual analog score)
minimum=0; maximum=10; higher score corresponds to more severe pain
Time frame: first 24 hours after the surgery
morphine consumption (mg)
total morphine consumption in 24 hours after the surgery
Time frame: first 24 hours after the surgery
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