PMID- 30140498
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2667-677X (Print)
IS  - 2149-276X (Electronic)
IS  - 2149-276X (Linking)
VI  - 46
IP  - 1
DP  - 2018 Feb
TI  - Donor Hepatectomy Surgery using Ketamine to Compliment Analgesia and Reduce 
      Morbidity - a Retrospective Chart Review Investigation.
PG  - 28-37
LID - 10.5152/TJAR.2017.33239 [doi]
AB  - OBJECTIVE: Inferior and limited analgesic options/techniques during living donor 
      hepatectomy surgery can result in pain and risks of morbidity, opioid-related 
      adverse events (AEs), predisposition to the development of chronic pain and 
      concerns of potential narcotic abuse. Traditional analgesia uses unimodal 
      intravenous opioids that can cause significant side effects. Ketamine provides 
      analgesia and may be opioid sparing, but use in living-donor hepatectomy has not 
      been studied. METHODS: Following human investigation committee approval and 
      informed written consent, 47 liver donor patients over a 5-year period scheduled 
      for surgery were categorized into one of three groups: 24 patients received no 
      ketamine (Group 1), 9 received only intraoperative ketamine (Group 2) and 14 
      patients received intraoperative plus postoperative ketamine (Group 3). Subjects 
      had access to opioid patient-controlled analgesia (PCA). Chart reviews (including 
      operating room and intensive care unit) were collected and analysed for morphine 
      consumption, pain-intensity scores, opioid-sparing effects, AEs of analgesics and 
      for evidence of ketamine side effects on donor hepatectomy patients. RESULTS: 
      There were no differences in patient demographics. Living donor hepatectomy 
      patients receiving intraoperative ketamine that was continued postoperatively 
      consumed fewer morphine-equivalents and had lower median pain scores than 
      subjects from the other two groups. Ileus occurred in those not receiving 
      ketamine, pruritus was lowest in Group 3, and there was no evidence or reports of 
      ketamine-associated AEs. CONCLUSION: Perioperative ketamine for donor hepatectomy 
      patients could safely provide improved analgesia and be opioid sparing when 
      compared to PCA opioids alone, and there is no evidence of ketamine-related AEs 
      at the dose and delivery methods described here during partial liver donation 
      surgery.
FAU - Halaszynski, Thomas M
AU  - Halaszynski TM
AUID- ORCID: 0000-0002-0376-4378
AD  - Department of Anesthesiology, Yale University School of Medicine, New Haven, USA.
FAU - Dai, Feng
AU  - Dai F
AUID- ORCID: 0000-0002-4407-7769
AD  - Department of Anesthesiology, Yale University School of Medicine, New Haven, USA.
FAU - Huang, Yili
AU  - Huang Y
AUID- ORCID: 0000-0001-5944-8342
AD  - Department of Anesthesiology, Yale University School of Medicine, New Haven, USA.
LA  - eng
PT  - Journal Article
DEP - 20171129
PL  - Turkey
TA  - Turk J Anaesthesiol Reanim
JT  - Turkish journal of anaesthesiology and reanimation
JID - 101680817
PMC - PMC5858885
OTO - NOTNLM
OT  - Living-donor liver transplantation
OT  - ketamine
OT  - perioperative analgesia
COIS- Conflict of Interest: No conflict of interest was declared by the authors.
EDAT- 2018/08/25 06:00
MHDA- 2018/08/25 06:01
PMCR- 2018/02/01
CRDT- 2018/08/25 06:00
PHST- 2017/01/10 00:00 [received]
PHST- 2017/07/28 00:00 [accepted]
PHST- 2018/08/25 06:00 [entrez]
PHST- 2018/08/25 06:00 [pubmed]
PHST- 2018/08/25 06:01 [medline]
PHST- 2018/02/01 00:00 [pmc-release]
AID - tard-46-1-28 [pii]
AID - 10.5152/TJAR.2017.33239 [doi]
PST - ppublish
SO  - Turk J Anaesthesiol Reanim. 2018 Feb;46(1):28-37. doi: 10.5152/TJAR.2017.33239. 
      Epub 2017 Nov 29.