Effect of low dose ketamine on remifentanil-induced hyperalgesia in burn patients undergoing escharectomy and skin grafting

Objective To study the effect of low-dose ketamine on remifentanil-induced hyperalgesia in burn patients undergoing escharectomy and skin grafting. Methods Sixty ASAⅠ-Ⅱburn patients aged 18-60 years who underwent escharectomy and skin grafting in First Affiliated Hospital of Chinese PLA General Hospital from June 2013 to December 2013 were enrolled in this study. The patients had a recipient area of 1%-30% and were anesthetized with sevofurane and 4 ng/ml remifentanil, and they were randomly divided into ketamine group and control group (30 in each group). The patients in ketamine group were injected with ketamine (0.3 mg/kg) followed by remifentanil3 μg/(kg·min) till the end of surgery, while those in control group were injected with an equal amount of 0.9% sodium chloride. Their intraoperative vital signs, visual analogue scale (VAS) score and morphine used through the patient controlled analgesia (PCA) pump 7 h after operation were compared. Results The VAS score within 3 h after operation and morphine used within 2 h after operation were signifcantly lower in ketamine group than in control group (P< 0.05). Conclusion Continuous infusion of low dose ketamine can decrease the remifentanil-induced hyperalgesia and the use of opioid in burn patients undergoing escharectomy and skin grafting.