{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T07:51:09Z","timestamp":1766908269288},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2001,12,24]],"date-time":"2001-12-24T00:00:00Z","timestamp":1009152000000},"content-version":"vor","delay-in-days":723,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2000,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Previous studies have shown that N\u2010methyl\u2010D\u2010asparate (NMDA) receptor antagonists provide a pre\u2010emptive analgesic effect in humans. This study investigated the benefits of pre\u2010emptive analgesia for upper abdominal surgery, using pre\u2010incisional epidural ketamine + morphine + bupivacaine (K+M+B) treatment for achieving postoperative pain relief.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Sixty ASA 1\u20132 patients scheduled for upper abdominal surgery were allocated to three groups in a randomized, single\u2010blinded study. Patients in the control group (I) received general anaesthesia followed by an infusion of normal saline. Group II and III patients received general anaesthesia with a continuous epidural infusion of 2% lidocaine. Thirty minutes after the incision in groups I and II, an epidural pain control regimen was administered using ketamine (10 mg) and morphine (1 mg) in 10 ml of 0.085% bupivacaine (K+M+B). Group III patients also received K+M+B, but it was administered 10 min after the 2% lidocaine injection and 30 min before skin incision. All patients received an epidural pain control regimen (q12 h) for 3 days after their first injection. Patient\u2010controlled analgesia (PCA) with morphine was used to control subsequent postoperative pain. During the 3\u2010day period following surgery, duration to PCA trigger (h), morphine consumption (mg), pain intensity at rest and when coughing\/moving, and analgesic\u2010related adverse effects were recorded. The VAS scale (0\u201310) was used to assess pain intensity.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Median times to first PCA trigger were 1.2 (0.5\u20132.0) h, 3.0 (0.7\u20134.2) h, and 4.0 (2.5\u20137.5) h for groups I, II, and III, respectively. Both the incident and resting pain scores were consistently lower for group III patients than groups I and II. The number of PCA triggers (all attempts\/successful triggers) during the day following surgery were 14.0 (3\u201330)\/8.0 (3\u201324) times, 10.0 (3\u201323)\/6.0 (2\u201320) times, and 7.0 (3\u201312)\/4.5 (1\u201310) times for groups I, II, and III. Total morphine consumption for the 3\u2010day observation period was 12.5 (3\u201342) mg, 10.5 (2\u201329) mg, and 6.0 (1\u201320) for groups I, II, and III, respectively.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Pre\u2010incisional epidural K+M+B treatment combined with continuous epidural anaesthesia and general anaesthesia provides an ideal pre\u2010emptive analgesic therapy, exhibiting better postoperative pain relief than general anaesthesia and post\u2010incisional K+M+B treatment.<\/jats:p>","DOI":"10.1034\/j.1399-6576.2000.440112.x","type":"journal-article","created":{"date-parts":[[2003,3,10]],"date-time":"2003-03-10T09:40:36Z","timestamp":1047289236000},"page":"63-68","source":"Crossref","is-referenced-by-count":71,"title":["Pre\u2010incisional epidural ketamine, morphine and bupivacaine combined with epidural and general anaesthesia provides pre\u2010emptive analgesia for upper abdominal surgery"],"prefix":"10.1111","volume":"44","author":[{"given":"C. T.","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. C.","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C.","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. M. S.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. L.","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. T.","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. S.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,12,24]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199377020-00026"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03014321"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(88)90287-4"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198409000-00008"},{"key":"e_1_2_6_6_2","first-page":"253","volume-title":"Neural blockade.","author":"Cousins MJ","year":"1988"},{"key":"e_1_2_6_7_2","first-page":"955","volume-title":"Neural blockade.","author":"Cousins MJ","year":"1988"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199501000-00026"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-6147(93)90005-5"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199412000-00018"},{"key":"e_1_2_6_11_2","first-page":"534","article-title":"Ketamine potentiates analgesic effect of morphine in postoperative epidural pain control.","volume":"21","author":"Wong CS","year":"1996","journal-title":"Reg Anesth"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/PL00013180"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1994.tb14226.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/69.1.4"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199703000-00025"},{"key":"e_1_2_6_16_2","first-page":"99","article-title":"Preoperative spinal bupivacaine does not reduce postoperative morphine requirement in women undergoing total abdominal hysterectomy.","volume":"21","author":"Dakin MJ","year":"1996","journal-title":"Reg Anesth"},{"key":"e_1_2_6_17_2","first-page":"124","article-title":"Evaluation of epidural sensory block by thermal stimulation, laser stimulation, and recording of somatosensory evoked potentials.","volume":"21","author":"Zaric D","year":"1996","journal-title":"Reg Anesth"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(88)90286-2"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/63.2.139"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199312000-00014"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199402000-00002"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199806000-00021"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199703000-00017"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1034%2Fj.1399-6576.2000.440112.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1034%2Fj.1399-6576.2000.440112.x","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1034\/j.1399-6576.2000.440112.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T10:34:47Z","timestamp":1698575687000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1034\/j.1399-6576.2000.440112.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2000,1]]}},"alternative-id":["10.1034\/j.1399-6576.2000.440112.x"],"URL":"https:\/\/doi.org\/10.1034\/j.1399-6576.2000.440112.x","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,1]]}}}