A comparative study on the effect of preemptive ketamine and paracetamol in the control of postoperative pain in lumbar disc herniation surgeries under spinal anesthesia

Abstract

Background: The aim of this study was to compare the efficacy of preemptive ketamine with paracetamol in control of postoperative pain in lumbar disc herniation surgeries under spinal anesthesia. Methods: In a clinical trial study, 75 patients undergoing lumbar disc surgery were randomly divided in three groups of 25 patients. Before surgery, in the first group, paracetamol (1 g) was intravenously injected during 10 minutes; in the second group, ketamine (0.2 mg/kg), and in the third group, normal saline was intravenously injected with the same volume. Pain intensity and other postoperative complications were compared between the three groups. Findings: The mean intensity of postoperative pain in three groups of paracetamol, ketamine, and control was 1.62 ± 0.87, 1.64 ± 1.15, and 2.52 ± 1.64 (P = 0.018) at the entrance to recovery, 1.84 ± 1.18, 1.76 ± 1.10, and 3.72 ± 1.97 (P < 0.001) at the 30th minutes recovery, and 1.84 ± 1.18, 1.92 ± 1.12, and 3.72 ± 1.65 (P < 0.001) at the 60th minute recovery, respectively, and the differences between the three groups were significant. Besides, the trend of pain intensity up to 60 minutes of recovery were different between the three groups, and the control group had a higher pain intensity (P = 0.001). Conclusion: The use of paracetamol has a good effect on postoperative pain management in spinal disk surgeries. Since paracetamol has low side effects, and is most commonly used by patients, it is preferable to ketamine. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.