Avalia？？o do efeito preemptivo da s(+)-cetamina por via peridural para histerectomia: concentra？？es plasmáticas de interleucinas

background and objectives: some studies showed that ketamine inhibits the production of cytokines. the objective of this study was to evaluate the preemptive analgesic effect of epidural s(+)-ketamine in hysterectomy and plasmatic cytokines (il-6, tnf-α and il-10). method: a double-blinded study with 29 patients was conducted. patients in group 1 received 13 ml of 0.25% bupivacaine with 25 mg of s(+)ketamine 30 minutes before surgical incision and 15 ml of saline solution via the epidural route 30 minutes after. patients in group 2 received 15 ml of saline solution 30 minutes before the surgical incision, followed by 13 ml of 0.25% bupivacaine with 25 mg of s(+)-ketamine 30 minutes after. postoperative analgesia was made with epidural bupivacaine and fentanyl. dipyrone 1 g was used whenever required. the following paramenters were evaluated: concentration of cytokines, intensity of pain, time of first request of analgesic and total quantity of analgesic used. results: time for the first request for analgesics was 61.5 minutes in group 1 and 69.0 in group 2, without difference between these groups. there was no difference for total dose of fentanyl used in group 1 (221.4 μg) and group 2 (223.3 μg). a similar analgesic effect was obtained in both groups, except in t12 (group 1 = 2.4 ± 3.2; group 2 = 5.5 ± 3.4). no differences in concentration of cytokines were observed. conclusions: the epidural injection of 25 mg s(+)-ketamine before incision reduced the pain intensity only 12 hours after surgical incision and did not alter concentration of cytokines