Comparative Study of Intravenous Regional Anaesthesia Lignocaine with Ketorolac versus Plain Lignocaine
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 4
Abstract
Aim: To prove the effectiveness of ketorolac as an adjuvant in intravenous regional anaesthesia. To know the effect of ketorolac on the tourniquet pain & post operative analgesia in IVRA. Materials and Methods: This is a prospective double blinded study conducted at Government Rajaji Hospital attached to Madurai Medical College. After approval by the ethical committee 50 patients of ASA grade I & II age between 20-70 years who came for upper limb surgeries which lasting for less than 60 minutes were included in this study. Patients with history of allergic to local anaesthetics, sickle cell disease, raynaud’s disease, scleroderma, local infection, pagets disease and patients with inadequate starvation <6 hours and patients who had contraindication to ketorolac were excluded from this study. Results: A (lignocaine only) and group B (lignocaine with ketorolac) patients were comparable in respect of age, sex, weight and duration of surgery. The onset of sensory blockade was similar in both the groups. But there was rapid onset of motor blockade in ketorolac group in this study. 24% patients (6 patients out of 25 patietns) need supplementation due to tourniquet pain compared to 64% patients (16 patients out of 25 patients) in the control group. The incidence of tourniquet pain in the ketorolac group was less and which statistically significant. The duration of sensory blockade after cuff deflation in study group and control group were 5.28+/- 5.34 miutes and 4.4+/- 2.44 minutes respectively. The duration of motor blockade after cuff deflation in study group and control group were 9.04+/-6.1 minutes and 7.6+/- 3.1 minutes. Though the duration of blockade found to be superior than that of control group, the difference in the effects between them were not statistically significant. The time for first analgesic requirement in study group and control group were 123.1+/-49.4 miutes and 19.4+/-11 miutes respectively. The differences between them were statistically significant. The lowest duration achieved in ketorolac group was 85 minutes and longest duration was 156 minutes. The difference between the group with respect to mean arterial pressure and pulse rate at 1minute and at 5 minutes was not statistically significant. Hence the groups were comparable with respect to mean arterial pressure and pulse rate at 1 minute and at 5 minutes after cuff deflation. There were no side effects noted in both the groups after cuff deflation. Conclusion: Ketorolac 20 mg which was added to lignocaine for IVRA provides less incidence of tourniquet pain, increases the duration of post operative analgesia and no significant increase in side effects and there was no haemodynamic changes.
Authors and Affiliations
R. Shanmgam
Keywords
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- EP ID EP472146
- DOI 10.21088/ijaa.2349.8471.4417.29
- Views 73
- Downloads 0
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