{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:24Z","timestamp":1772168844740,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.127562.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000}}],"reference-count":32,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background:<\/ns3:bold>\n                    Postoperative pain increases the risk of postoperative complications and may predispose patients to chronic post-surgical pain. This study aims to evaluate the impact of ketamine wound infiltration versus placebo at the end of thyroid surgery on postoperative pain and analgesic requirements.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods:<\/ns3:bold>\n                    In this randomized controlled trial, we prospectively studied patients who underwent thyroid surgery. Patients were randomized into two groups: group S, where local infiltration was performed using 10 ml of a physiological saline solution; and group K, where 10 ml of a solution containing 2 mg\/kg ketamine was infiltrated. Standardized thyroidectomies were performed in the 2 groups. Pain perception was measured using a visual analog scale (VAS) every 10 minutes in the post-anesthetic care unit (PACU) for 2 hours and thereafter every 6 hours during the first 24 hours. The opioid requirement in the PACU was evaluated.\u00a0A comparison between the 2 groups was carried out.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results:<\/ns3:bold>\n                    Postoperatively, the mean VAS was higher in group S compared to group K during all PACU stay periods and the first 24 hours. Pain scores during swallowing were significantly lower for group K in the PACU at 0, 10, and 20 minutes. The mean morphine consumption in the PACU was 0.71 mg and 0 mg respectively in group S and group K (p=0.03). The incidence of nausea and vomiting was similar in both groups.\u00a0\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    Ketamine wound infiltration is an efficient modality to reduce postoperative opioid consumption compared to a placebo after thyroid surgery.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.127562.2","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T06:24:28Z","timestamp":1692339868000},"page":"206","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ketamine infiltration improves analgesia after thyroid surgery"],"prefix":"10.12688","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2409-3996","authenticated-orcid":false,"given":"Moncef","family":"Sellami","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1638-8065","authenticated-orcid":false,"given":"Imen","family":"Zouche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9296-762X","authenticated-orcid":false,"given":"Mariam","family":"Ben Ayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maroua","family":"Bouhali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khadija","family":"Ben Ayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salma","family":"Ktata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boutheina","family":"Hammami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0880-1032","authenticated-orcid":false,"given":"Mohamed Amine","family":"Chaabouni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilhem","family":"Charfeddine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2338-2343","DOI":"10.1007\/s00268-010-0698-7","article-title":"Bilateral superficial cervical plexus block combined with general anesthesia administered in thyroid operations.","volume":"34","author":"M Shih","year":"2010","journal-title":"World J. Surg."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"264-270","DOI":"10.2478\/v10035-011-0041-5","article-title":"Local anesthesia in thyroid surgery \u2013 Own experience and review of the literature.","volume":"83","author":"T Banasiewicz","year":"2011","journal-title":"Pol. Przegl. Chir."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1884-1898","DOI":"10.1213\/01.ANE.0000219597.16143.4D","article-title":"Risk factors for postoperative nausea and vomiting.","volume":"102","author":"T Gan","year":"2006","journal-title":"Anesth. Analg."},{"key":"ref4","first-page":"11-13","article-title":"Postoperative pain scores and analgesic requirements after thyroid surgery: comparison of three intraoperative opioid regimens.","volume":"3","author":"C Motamed","year":"2006","journal-title":"Int. J. Med. Sci."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"241-251","DOI":"10.1016\/j.bja.2017.11.083","article-title":"Analgesic efficacy of bilateral superficial cervical plexus block for thyroid surgery: meta-analysis and systematic review.","volume":"120","author":"D Mayhew","year":"2018","journal-title":"Br. J. Anaesth."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1001-1008","DOI":"10.1016\/j.asjsur.2019.01.017","article-title":"Randomized controlled trial comparing bilateral superficial cervical plexus block and local wound infiltration for pain control in thyroid surgery.","volume":"42","author":"S Hoh","year":"2019","journal-title":"Asian J. Surg."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4659","DOI":"10.3390\/jcm10204659","article-title":"Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review.","volume":"10","author":"D Stamenkovic","year":"2021","journal-title":"J. Clin. Med."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s13104-020-4907-7","article-title":"The analgesic efficacy of bilateral superficial cervical plexus block for thyroid surgery under general anesthesia: a prospective cohort study.","volume":"13","author":"Y Woldegerima","year":"2020","journal-title":"BMC. Res. Notes."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"53-58","DOI":"10.1097\/AJP.0000000000000521","article-title":"Efficacy of Postoperative Analgesia of Local Ketamine Wound Instillation Following Total Thyroidectomy: A Randomized, Double-blind, Controlled Clinical Trial.","volume":"34","author":"A Abd El-Rahman","year":"2018 Jan","journal-title":"Clin. J. Pain."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1265-1270","DOI":"10.1007\/s00405-018-4933-4","article-title":"Bupivacaine wound infiltration reduces postoperative pain and analgesic requirement after thyroid surgery.","volume":"275","author":"M Sellami","year":"2018","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2656-2666","DOI":"10.1007\/s00268-020-05458-6","article-title":"A Double-Blind, Randomized Controlled Trial of Pre-incision Wound Infiltration Using Diclofenac Versus Bupivacaine for Post-operative Pain Relief in Open Thyroid and Parathyroid Surgery.","volume":"44","author":"J Loh","year":"2020","journal-title":"World J. 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Scand."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1109-1120","DOI":"10.1177\/0300060517734679","article-title":"Efficacy of ketamine for postoperative pain following robotic thyroidectomy: A prospective randomised study.","volume":"46","author":"J Lee","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"173-177","DOI":"10.5152\/UCD.2015.3138","article-title":"Local bupivacaine for postoperative pain management in thyroidectomized patients: A prospective and controlled clinical study.","volume":"32","author":"E Dumlu","year":"2015","journal-title":"Ulus Cerrahi Derg."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"193-202","DOI":"10.23736\/S0026-4733.20.08255-3","article-title":"The effect of bupivacaine on postoperative pain following thyroidectomy: a systematic review and meta-analysis.","volume":"75","author":"Y Jiang","year":"2020","journal-title":"Minerva Chir."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s12871-019-0835-2","article-title":"Multimodal analgesia with ropivacaine wound infiltration and intravenous flurbiprofen axetil provides enhanced analgesic effects after radical thyroidectomy: a randomized controlled trial.","volume":"19","author":"X Li","year":"2019 Aug 31","journal-title":"BMC Anesthesiol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"826-833","DOI":"10.1038\/sj.bjp.0706385","article-title":"Ketamine impairs excitability in superficial dorsal horn neurones by blocking sodium and voltage-gated potassium currents.","volume":"146","author":"R Schnoebel","year":"2005","journal-title":"Br. J. Pharmacol."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"17370-17382","DOI":"10.1523\/JNEUROSCI.4152-11.2011","article-title":"Microglial Ca(2+)-activated K(+) channels are possible molecular targets for the analgesic effects of S-ketamine on neuropathic pain.","volume":"31","author":"Y Hayashi","year":"2011","journal-title":"J. Neurosci."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"403-410","DOI":"10.1111\/cns.12104","article-title":"Ketamine and peripheral inflammation.","volume":"19","author":"M De Kock","year":"2013","journal-title":"CNS Neurosci. Ther."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e5485","DOI":"10.1097\/MD.0000000000005485","article-title":"Prospective, randomized, and controlled trial on ketamine infusion during bilateral axillo-breast approach (BABA) robotic or endoscopic thyroidectomy: Effects on postoperative pain and recovery profiles: A consort compliant article.","volume":"95","author":"D Kim","year":"2016","journal-title":"Medicine (Baltimore)."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e101259","DOI":"10.1371\/journal.pone.0101259","article-title":"Efficacy of ketamine in improving pain after tonsillectomy in children: meta-analysis.","volume":"9","author":"H Cho","year":"2014","journal-title":"PLoS One."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"559-564","DOI":"10.1007\/s00540-017-2353-z","article-title":"Comparison of topical ropivacaine with and without ketamine on post-surgical pain in children undergoing tonsillectomy: a randomized controlled double-blind study.","volume":"31","author":"B Hong","year":"2017","journal-title":"J. Anesth."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"263-269","DOI":"10.1111\/j.1460-9592.2006.02095.x","article-title":"The efficacy of intravenous or peritonsillar infiltration of ketamine for postoperative pain relief in children following adenotonsillectomy.","volume":"17","author":"D Dal","year":"2007","journal-title":"Paediatr. Anaesth."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"947-961","DOI":"10.1111\/anae.15299","article-title":"PROSPECT Working Group collaborators*: PROSPECT guideline for tonsillectomy: systematic review and procedure-specific postoperative pain management recommendations.","volume":"76","author":"N Aldamluji","year":"2021","journal-title":"Anaesthesia."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"401-406","DOI":"10.1111\/pan.12124","article-title":"A randomized study of surgical site infiltration with bupivacaine or ketamine for pain relief in children following cleft palate repair.","volume":"23","author":"A Jha","year":"2013","journal-title":"Paediatr. Anaesth."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2386-2400","DOI":"10.1016\/j.joms.2019.07.002","article-title":"Local Ketamine Improves Postoperative Analgesia After Third Molar Surgery.","volume":"77","author":"V Esparza-Villalpando","year":"2019","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1-6","DOI":"10.2147\/JPR.S26476","article-title":"Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy.","volume":"5","author":"A Honarmand","year":"2012","journal-title":"J. Pain Res."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1418-1426","DOI":"10.1111\/j.1526-4637.2011.01205.x","article-title":"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.","volume":"12","author":"M Safavi","year":"Sept 2011","journal-title":"Pain Med."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"645-655","DOI":"10.1136\/rapm-2020-101593","article-title":"Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review.","volume":"45","author":"J Bai","year":"2020 Aug","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref29","doi-asserted-by":"publisher","article-title":"Underlying data for \u2018Ketamine infiltration decreases opioid requirement after thyroid surgery\u2019.","author":"M Sellami","DOI":"10.6084\/m9.figshare.21365703.v1"}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/12-206\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-206\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-206\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:25:14Z","timestamp":1706747114000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/12-206\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,18]]},"references-count":32,"URL":"https:\/\/doi.org\/10.12688\/f1000research.127562.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.154754.r197863","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.154754.r235357","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.154754.r235357","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.154754.r197863","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,18]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/12-206\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.154754.r197863, Chihebeddine Romdhani, Widd Kaabi, Research Unit UR17DN05, Military Hospital of Tunis, Tunis, 04 Sep 2023, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-206\/v2#referee-response-197863","order":0,"name":"referee-response-197863","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.140082.r187838, Mohamed Kahloul, Department of Anesthesia and Intensive Care, Sahloul Academic Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Sousse, 10 Aug 2023, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/12-206\/v1#referee-response-187838","order":1,"name":"referee-response-187838","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Moncef Sellami<\/b>; \n<i>Posted: 17 Aug 2023<\/i>; \n<b>We express our gratitude to the reviewer for his meticulous assessment, which has contributed significantly to the refinement of our study.<\/b> Title:  Postoperative opioid requirements were assessed only in the PACU. Postoperative pain is your primary outcome. Please rephrase your title.  \n<b>Author response: The title has been revised as 'Ketamine infiltration improves analgesia after thyroid surgery'.<\/b> Methods:  Difficult airways should be considered as an&nbsp; exclusion criteria because you had assessed VAS during swallowing. &nbsp; Please precisely include which ketamine concentration was used.  \n<b>Author response: <\/b>  \n<b>In effect, difficult airways were considered an exclusion criterion.<\/b> \n<b>We specified the ketamine concentration used, which was 50mg\/ml<\/b>  Results:  Baseline characteristics should be comparable between the two groups. Please verify your data (age, performed surgery). &nbsp; You have many VAS assessments exceeding 3\/10. What was your rescue analgesia?  \n<b>Author response:<\/b>  \n<b>The patients were randomized and the results were statistically verified.<\/b> \n<b>Our data, including age and type of surgery, have been carefully validated.<\/b> \n<b>We specified that the rescue analgesic during hospitalization was Nefopam in the case of VAS values greater than 30<\/b>  Discussion :  The choice of ketamine dosage should be discussed.  \n<b>Author response: In our study, we infiltrated a solution containing 2 mg\/kg ketamine based on established literature and clinical experience, in order to achieve effective analgesia while minimizing potential adverse effects. <\/b> \n<b>We discuss the chosen dose.<\/b>  &quot;However, the use of ropivacaine was not associated with an analgesic effect.\n<sup>12<\/sup>\n<sup>&quot;<\/sup>&nbsp;Others studies had found different results and they should be considered\n<sup>1<\/sup>.  \n<b>Author response:<\/b> \n<b>We discussed this issue and reported the study by Li X et al.<\/b> &nbsp;  VAS was considered as a limitation while it is a validated tool.  \n<b>Author response:<\/b> \n<b>We have considered the reviewer's comment and revised the limitations section of the study. Indeed, the VAS is a validated tool despite its subjective nature.<\/b> Conclusion:  Please put \u201cto reduce\u201d instead of \u201cto reducing\u201d.  \n<b>Author response:<\/b> \n<b>We have made the requested change, replacing &quot;to reducing&quot; with &quot;to reduce&quot; in the relevant section.<\/b>","URL":"https:\/\/f1000research.com\/articles\/12-206\/v2#referee-comment-10075","order":2,"name":"referee-comment-10075","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.154754.r235357, Pham Quang Minh, Hanoi Medical University, Hanoi, 01 Feb 2024, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-206\/v2#referee-response-235357","order":3,"name":"referee-response-235357","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}