Low-Dose Ketamine for Outpatient Hysteroscopy: A Prospective, Randomised, Double-Blind Study

Özet

Objective: Outpatient hysteroscopy is often accompanied by pain and discomfort along with frequent occurrence of bradycardia andhypotension. This study aimed to observe if intravenous low-dose ketamine reduces the pain scores along with lowering the incidence ofbradycardia and hypotension during hysteroscopy.Methods: This prospective, randomised, double-blind trial was conducted in operating rooms in a tertiary care hospital. In this study, weenrolled 72 patients with American Society of Anesthesiologists status I to II undergoing hysteroscopy. We randomised patients into twogroups, and both groups received paracervical block. The control group received intravenous pentazocine and promethazine along withsaline infusion. The ketamine group received ketamine infusion (0.75 mg kg−1 bolus followed by infusion at the rate of 10 mcg kg−1 min−1). Weanalysed visual analogue scale (VAS), rescue analgesic consumption, hemodynamic parameters, lowest recorded heart rate, blood pressure,level of sedation, patient’s comfort, surgeon’s satisfaction and nursing staff’s satisfaction.Results: Analysis of the data revealed that the pain scores were similar in both the groups (p=0.493, p<0.001). Rescue analgesic was requiredby 47% patients in control group, compared to only 5.6% patients in ketamine group. Episodes of bradycardia and hypotension were morepronounced in the control group than in the ketamine group [77.4±10.9 vs. 78.4±5.5; 67.6±8 vs. 70.1±6 respectively] (p<0.001). Patientcomfort and surgeon’s satisfaction were higher in the ketamine group, but nursing satisfaction was higher in the control group. Disorientationwas present in 75% patients in the ketamine group as compared to none in the control group.Conclusion: We concluded that low-dose ketamine in day-care hysteroscopy is an effective and safe agent.