Effectiveness of Subcutaneous Ketamine Injection at the Port Site for Postoperative Pain Management Following Laparoscopic Surgery: A Randomized Controlled Trial

Abstract

Background and Objective: Effective control of postoperative pain is a vital component of patient recovery after laparoscopic interventions. Although laparoscopic surgery is associated with smaller incisions, the patient still experiences significant postoperative pain, often due to tissue trauma, port site irritation, and peritoneal stretching. This study investigates the analgesic efficacy of subcutaneous ketamine at the port site in reducing postoperative laparoscopic pain.

Methods: This prospective, randomized controlled trial was conducted at Shar Hospital, Sulaymaniyah, over four months, enrolling 100 patients aged 18–65 years undergoing elective laparoscopic surgery. Participants were randomly assigned to two equal groups: the intervention group received subcutaneous ketamine infiltration at the port site, whereas the control group received normal saline. Baseline demographics and preoperative pain scores were recorded. Postoperative pain intensity was assessed at 1, 6, and 12 hours using a 0–10 numerical rating scale. Statistical analysis employed repeated-measures ANOVA and ANCOVA.

Results: Baseline characteristics were comparable (p > 0.05). Pain scores were significantly lower in the ketamine group at 1 hour (p < 0.001), 6 hours (p < 0.001), and 12 hours (p < 0.001). Within-group pain reduction was also significant over time (p < 0.001). Adverse effects were mild but more frequent with ketamine, including nausea (20%), vomiting (14%), dizziness (28%), and tachycardia (10%).

Conclusion: Subcutaneous ketamine injection at the port site markedly reduces postoperative pain following laparoscopic surgeries. This treatment has few side effects and appears to be a complement to conventional pain relief techniques.