A Comparative Study Between Morphine, Dexmedetomidine And Ketamine as an Adjunct to Levobupivacaine in Paravertebral Block During Modified Radical Mastectomy
Journal Title: PARIPEX-Indian Journal of Research - Year 2016, Vol 5, Issue 10
Abstract
Background: To compare the effects of morphine, dexmedetomidine and ketamine administered in paravertebral block as adjunct to levobupivacaine conduct a prospective, randomised, controlled single blind, clinical study. Methods: A total of 120 breast cancer patients aged between 18-60 years of ASA I-II scheduled for elective modified radical mastectomy were comprises to four groups (30 in each): paravertebral block with 0.25% levobupivacaine (19 ml) with 1ml normal saline (group C), with 1 ml (5 mg) morphine (group M), with 1 ml (25 μg) dexmedetomidine (group D) and with 1ml (25 mg) ketamine (group K). All patients were given premedication on the night before surgery with ranitidine 150 mg and alprazolam 0.25 mg orally. Results: The heart rate and MAP were almost stable in the intra-operative period. The SpO2 remained 97-100% in the intraoperative period among all the groups. VAS was significantly (p<0.05) different among the groups at 8 hours to 20 hours. The first requirement of rescue analgesia was significantly (p=0.0001) among the groups postoperatively. Total consumption of antemetic was among 16.3% of the patients in group M only. Hypotension was found among 6.6% in group D only and respiratory depression in 6.6% of group M patients. Conclusion: Our results suggest that the dexmedetomidine (25 μg) with levobupivacaine (0.25%) for paravertebral block, during modified radical mastectomy, prolongs the duration of analgesia and decreased the rescue analgesia with significantly reduced the incidence of postoperative adverse effects.
Authors and Affiliations
Anshu Singh, Jitendra Kumar Kushwaha, Rajni Gupta, Prithvi Kumar Singh, Reetu Verma, Ravi Kumar, Jaishri Bogra, Abhinav A. Sonkar, Anuradha Nischal
Keywords
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