Analgesic Effect of Ketamine in Patients Undergoing Hysteroscopic Endometrial Thermal Ablation Surgery

• Total dose of intraoperative opioid [ Time Frame: intra operative period ] [ Designated as safety issue: No ]
  Total dose of intraoperative opioids used
• Opiate related side effects: Nausea, vomiting, retching, sedation [ Time Frame: 24 hours post operatively ] [ Designated as safety issue: Yes ]
  Number of opiate related side effects: Nausea, vomiting, retching, sedation

Hypothesis: The intraoperative administration of ketamine will result in a 30% reduction in opiate requirement following endometrial ablation surgery and the intraoperative administration of ketamine will result in a decreased time to meet discharge criteria in the PACU following endometrial ablation surgery.

The research question is "Does intraoperative administration of ketamine result in decreased postoperative opiate requirement and time to discharge from the postanesthesia recovery unit (PACU) following hysteroscopic endometrial ablation".

• Drug: Saline
  Saline continuous infusion
• Drug: Ketamine continuous infusion
  Ketamine continuous infusion

• Placebo Comparator: Group A: Saline group
  Group A: Saline group , infusion of saline
  Intervention: Drug: Saline
• Active Comparator: Group B: 1% Ketamine group
  Infusion of ketamine
  Intervention: Drug: Ketamine continuous infusion

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Inclusion Criteria:

• Gender: Female
• Age: 18-65 years
• Non-pregnant, non-lactating
• Surgery: Outpatient hysteroscopic Novasure® endometrial ablation
• Language: English speaking
• Consent: Obtained

Exclusion Criteria:

• Patient refusal
• Under 18 or over age 65
• Non-English Speaking
• Pregnancy, Breast feeding
• Hysteroscopic procedures using Thermachoice® ablation device
• Chronic use or addiction to opiates, sedatives, non-opiate analgesics
• History of heavy alcohol usage (>4 drinks/day)
• Significant cardiovascular or pulmonary disease
• Psychiatric or emotional disorder
• Allergy to anesthetic agents utilized in the protocol
• Glaucoma
• Thyrotoxicosis