Intravenous Lidocaine Infusion with Single Low-Dose Ketamine as an Adjuvant to General Anesthesia in Posterior Spine Fusion

Abstract

Background: Posterior spinal fusion (PSF) is used to correct degeneration of the lumbar spine with considerable postoperative pain. We aimed to compare the total intraoperative and postoperative opioid consumption and numeric pain scale between the lidocaine/ketamine group and the narcotic-only group. Materials and Methods: Sixty adult patients (age 18–65 years) planned for elective PSF were included. Patients were randomly allocated into the lidocaine/ketamine group (LK group), who received lidocaine and ketamine injection and usual perioperative narcotic analgesia, and the narcotic-only group (N group), who depended on the N narcotics only. The primary outcome measures were total intraoperative and postoperative opioid consumption and pain scores during the first 24 hours postoperatively. The secondary outcome measures included sedation score, intravenous rescue analgesia, pruritis, and postoperative nausea and vomiting during the first 24 hours postoperatively. Results: Patients in the LK group had lower intraoperative fentanyl consumption (216.3±28.8 μg) than those in the N group (363±35 μg). The LK group consumed less morphine in the first 24 hours following surgery (49.5±6.0 mg) than the N group (57.8±8.6 mg). The LK group reported reduced pain scores at all-time intervals during the first 24 hours (2, 6, 12, and 24 hours) than the N group did. Conclusion: Intraoperative lidocaine infusion combined with low-dose ketamine reduced narcotic consumption and pain scores in patients undergoing PSF.