Effect of intrathecal ketamine as an adjuvant on the dose of intrathecal bupivacaine
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 2, Issue 1
Abstract
Background: A randomized control study was done to evlauate the effect of ketamine on the dose of bupivacaine when added as an adjuvant to intrathecal bupivacaine. Materials and Methods: 90 patients were divided randomly into 3 groups of 30 each. Group - 1 received 0.5% heavy Bupivacaine 3cc, Group 2 received 0.5% heavy Bupivacaine +preservative free ketamine 25mg. Group 3 received 0.5% heavy Bupivacaine 2.5cc + 0.5cc normalsaline. All patients after thorough checkup, after obtaining informed consent, recording basal parameters were shifted to O.T. Spinal anaesthesia was given in sitting position in L3-L4 space with 25G Quincke spinal needle, group specific drug was injected and immediately made supine. Monitoring was done by another person. Time of onset of T12 blockade, height of blockade, onset and duration of motor and sesory blockade and haemodynamic parameters were noted down. Observations and Results: Onset of sensory block, motor block were fast with Gr 2 then Gr 1 lastly with Gr3. Intensity of motor block (assessed by modified Bromage scale) is good with Gr1, then with Gr 2 and last with Gr 3. Haemodynamics are better maintained with Gr 2 than Gr 1. Recoveryfrom block (2 segment regression) was early in Gr 3 then Gr 2 last with Gr 1 motor block. Conclusion: When preservative free ketamine 25mg is added to bupivacaine 2.5 cc (0.5% heavy) produces early and good analgesia, adequate relaxation for infraumbilical surgeries compared to 2.5cc of Bupivacaine alone and better maintained haemodynamics and early recovery from block than 3cc of Buppivacaine so that dose of intrathecal dose of Bupivacaine can be reduced.
Authors and Affiliations
VijayaRekha Koti, Sarath Babu Chevuri, Mohammed Umer majid, Syeda Huma Gulbadeen
Keywords
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