Anesthesiology and Pain Medicine

Published by: Kowsar

Combined Ketamine-Tramadol Subcutaneous Wound Infiltration for Multimodal Postoperative Analgesia: A Double-Blinded, Randomized Controlled Trial after Renal Surgery

Mohammad Reza Khajavi 1 , Marzieh Navardi 1 , Reza Shariat Moharari 1 , Pejman Pourfakhr 1 , Narjes Khalili 2 , Farhad Etezadi 1 and Farsad Imani 1 , *
Authors Information
1 Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Community and Preventive Medicine Specialist, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
Article information
  • Anesthesiology and Pain Medicine: October 01, 2016, 6 (5); e37778
  • Published Online: July 26, 2016
  • Article Type: Research Article
  • Received: March 12, 2016
  • Revised: June 12, 2016
  • Accepted: July 10, 2016
  • DOI: 10.5812/aapm.37778

To Cite: Khajavi M R, Navardi M, Shariat Moharari R, Pourfakhr P, Khalili N, et al. Combined Ketamine-Tramadol Subcutaneous Wound Infiltration for Multimodal Postoperative Analgesia: A Double-Blinded, Randomized Controlled Trial after Renal Surgery, Anesth Pain Med. 2016 ; 6(5):e37778. doi: 10.5812/aapm.37778.

Copyright © 2016, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Imani F. Postoperative pain management. Anesth Pain Med. 2011; 1(1): 6-7[DOI][PubMed]
  • 2. Hosseini Jahromi SA, Hosseini Valami SM, Hatamian S. Comparison between effect of lidocaine, morphine and ketamine spray on post-tonsillectomy pain in children. Anesth Pain Med. 2012; 2(1): 17-21[DOI][PubMed]
  • 3. Abbasivash R, Aghdashi MM, Sinaei B, Kheradmand F. The effects of propofol-midazolam-ketamine co-induction on hemodynamic changes and catecholamine response. J Clin Anesth. 2014; 26(8): 628-33[DOI][PubMed]
  • 4. Atashkhoyi S, Negargar S, Hatami-Marandi P. Effects of the addition of low-dose ketamine to propofol-fentanyl anaesthesia during diagnostic gynaecological laparoscopy. Eur J Obstet Gynecol Reprod Biol. 2013; 170(1): 247-50[DOI][PubMed]
  • 5. Persson J. Ketamine in pain management. CNS Neurosci Ther. 2013; 19(6): 396-402[DOI][PubMed]
  • 6. Visser E, Schug SA. The role of ketamine in pain management. Biomed Pharmacother. 2006; 60(7): 341-8[DOI][PubMed]
  • 7. Vuyk J, Sitsen E, Reekers M. Intravenous anesthetics. 2015; : 848-50
  • 8. Altunkaya H, Ozer Y, Kargi E, Babuccu O. Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures. Br J Anaesth. 2003; 90(3): 320-2[PubMed]
  • 9. Nasr YM, Waly SH. Lidocaine-tramadol versus lidocaine-dexmedetomidine for intravenous regional anesthesia. Eg J Anaesth. 2012; 28(1): 37-42
  • 10. Zeidan A, Kassem R, Nahleh N, Maaliki H, El-Khatib M, Struys MM, et al. Intraarticular tramadol-bupivacaine combination prolongs the duration of postoperative analgesia after outpatient arthroscopic knee surgery. Anesth Analg. 2008; 107(1): 292-9[DOI][PubMed]
  • 11. Carstensen M, Moller AM. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: a qualitative review of randomized trials. Br J Anaesth. 2010; 104(4): 401-6[DOI][PubMed]
  • 12. Imani F, Faiz H, Sedaghat M, Hajiashrafi M. Effects of adding ketamine to fentanyl plus acetaminophen on postoperative pain by patient controlled analgesia in abdominal surgery. Anesth Pain Med. 2013; 4(1)
  • 13. Shariat Moharari R, Lajevardi M, Khajavi M, Najafi A, Shariat Moharari G, Etezadi F. Effects of intra-operative ketamine administration on postoperative catheter-related bladder discomfort: a double-blind clinical trial. Pain Pract. 2014; 14(2): 146-50[DOI][PubMed]
  • 14. Moharari R, Hadavi M, Pourfakhr P, Najafi A, Etezadi F, Khajavi M. Evaluation of the postoperative analgesic efficacy of intraperitoneal ketamine compared with bupivacaine in laparoscopic cholecystectomy. AACC. 2016; 2(1): 146-9
  • 15. Shariat Moharari R, Valizadeh A, Najafi A, Etezadi F, Hosseini SR, Khashayar P, et al. Analgesic efficacy of nephrostomy tract infiltration of bupivacaine and ketamine after tubeless percutaneous nephrolithotomy: A prospective randomized trial. IJPR . 2016; 15(2): 619-26
  • 16. Safavi M, Honarmand A, Nematollahy Z. Pre-incisional analgesia with intravenous or subcutaneous infiltration of ketamine reduces postoperative pain in patients after open cholecystectomy: a randomized, double-blind, placebo-controlled study. Pain Med. 2011; 12(9): 1418-26[DOI][PubMed]
  • 17. Behaeen K, Soltanzadeh M, Nesioonpour S, Ebadi A, Olapour A, Aslani SM. Analgesic effect of low dose subcutaneous ketamine administration before and after cesarean section. Iran Red Crescent Med J. 2014; 16(3)[DOI][PubMed]
  • 18. Nejati A, Golshani K, Lakeh M, Khashayar P, Moharari R. Ketamine improves nasogastric tube insertion. Emergency Med J. 2010;
  • 19. Moharari RS, Najafi A, Khajavi MR, Moharari GS, Nikoobakht MR. Intraurethral instillation of ketamine for male rigid cystoscopy. J Endourol. 2010; 24(12): 2033-6[DOI][PubMed]
  • 20. Khajavi MR, Aghili SB, Moharari RS, Najafi A, Mohtaram R, Khashayar P, et al. Subcutaneous tramadol infiltration at the wound site versus intravenous administration after pyelolithotomy. Ann Pharmacother. 2009; 43(3): 430-5[DOI][PubMed]
  • 21. Ugur KS, Karabayirli S, Demircioglu RI, Ark N, Kurtaran H, Muslu B, et al. The comparison of preincisional peritonsillar infiltration of ketamine and tramadol for postoperative pain relief on children following adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 2013; 77(11): 1825-9[DOI][PubMed]
  • 22. Honarmand A, Safavi M, Karaky H. Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy. J Pain Res. 2012; 5: 1-6[DOI][PubMed]
  • 23. Reeves M, Lindholm DE, Myles PS, Fletcher H, Hunt JO. Adding ketamine to morphine for patient-controlled analgesia after major abdominal surgery: a double-blinded, randomized controlled trial. Anesthesia Analgesia. 2001; 93(1): 116-20
  • 24. El Deeb A, El-Morsy GZ. Comparison of preemptive analgesic effect of intravenous ketorolac versus tramadol in pediatric inguinal herniotomy: A randomized double blind study. Eg J Anaesth. 2011; 27(4): 207-11
  • 25. Subramaniam K, Subramaniam B, Steinbrook RA. Ketamine as adjuvant analgesic to opioids: a quantitative and qualitative systematic review. Anesth Analg. 2004; 99(2): 482-95[DOI][PubMed]
  • 26. Webb AR, Skinner BS, Leong S, Kolawole H, Crofts T, Taverner M, et al. The addition of a small-dose ketamine infusion to tramadol for postoperative analgesia: a double-blinded, placebo-controlled, randomized trial after abdominal surgery. Anesth Analg. 2007; 104(4): 912-7[DOI][PubMed]
  • 27. Weinbroum AA. Non-opioid IV adjuvants in the perioperative period: pharmacological and clinical aspects of ketamine and gabapentinoids. Pharmacol Res. 2012; 65(4): 411-29[DOI][PubMed]
  • 28. Sigtermans MJ, van Hilten JJ, Bauer MC, Arbous MS, Marinus J, Sarton EY, et al. Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1. Pain. 2009; 145(3): 304-11[DOI][PubMed]
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