The combination of intravenous dexamethasone and ketamine does not improve postoperative analgesia when compared to each drug individually

Abstract Objectives: Ketamine and dexamethasone have been reported to improve postoperative analgesia and chronic post-surgical pain. In patients undergoing inguinal hernia repair, we have compared the effects of each drug individually with their combination. Patients and methods: Sixty male patients randomly distributed in three groups, received double-blind: (i) dexamethasone 8 mg, 1 h before surgery (Group D); (ii) a bolus of ketamine 0.5 mg/kg after endotracheal intubation (Group K); or (iii) their combination (Group DK). Anaesthesia was maintained with sevoflurane and remifentanil. Dexketoprofen (50 mg, i.v.), paracetamol (1 g, i.v.) and wound infiltration with bupivacaine were used before closing. In the recovery room, boluses of 25 mg of tramadol were administered every 15 min until a visual analogue scale (VAS) score of less than 3 was recorded. After discharge, ibuprofen plus paracetamol was used for analgesia. Postoperatively, we assessed pain intensity (VAS 0–10), tramadol consumption, and adve...