A Comparative Study on the Use of Ketamine and Apotel Infusion Pump for the Control of Pain After Posterior Fusion Operations: A Randomized Controlled Trial

Background: Postoperative pain has many adverse effects and if not properly controlled, it can cause a wide range of problems. Objectives: The purpose of this study is to compare the results of using ketamine and apotel infusion pumps to control pain after posterior fusion surgery. Methods: In this clinical trial study, 72 patients hospitalized for posterior spine fusion surgery were randomly assigned into two groups, including ketamine infusion pumps (ketamin group) and apotel infusion pumps (apotel group). In the ketamin group, 0.2 mg/kg/h of ketamine was infused to by a pain pump with normal saline to 100 cc. In the apotel group, apotel was used instead of ketamine. The rate of pain was evaluated in recovery, and at 6, 12, 18, 24, and 48 hours after the surgery, based on VAS criteria. The rate of sedation was recorded based on Ramsy score. Results: There was no significant difference between age, sex, BMI, underlying diseases, and smoking in patients with posterior spinal fusion surgery between the groups. Postoperative pain score was significantly lower in the patients with posterior fusion surgery at 6, 12, 18, 24, and 48 hours in the ketamin group compared to the apotel group (P < 0.001). Patients’ satisfaction with the analgesia was significantly higher in the patients at 24 hours (P = 0.001) and 48 hours (P = 0.04) in the ketamine group compared to the apotel. With regards to the Ramsy scores of the patients with posterior fusion surgery, there was no significant difference between the groups (P = 0.16). Conclusions: The use of a ketamine infusion pump can be more effective than an apotel infusion pump to control pain after posterior fusion surgery.