INTRATHECAL PRESERVATIVE-FREE KETAMINE WITH BUPIVACAINE IN COMPARISON WITH BUPIVACAINE ALONE FOR LOWER LIMB AND LOWER ABDOMINAL SURGERIES- A CLINICAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 42
Abstract
BACKGROUND Pain relief is a basic human right and failure to relieve pain is morally and ethically unacceptable. The concept of postoperative pain relief and its utilisation has improved dramatically over recent years. In the present study intrathecal administration of ketamine is evaluated with respect to its anaesthetic properties, intraoperative and post-operative haemodynamic profile and duration of analgesia. MATERIALS AND METHODS 60 ASA Grade 1 and 2 patients undergoing lower limb and lower abdominal surgery under spinal anaesthesia were included in two groups of thirty each to receive intrathecal bupivacaine with ketamine and intrathecal bupivacaine alone. Onset of sensory blockade up to T10 level, intraoperative and postoperative vital signs, duration of analgesia and side effects, if any were evaluated. RESULTS It was found that the onset of sensory block in the Bupivacaine only group was 129.67 sec (Mean), while in the Bupivacaine plus Ketamine group it was 92.5 sec (Mean) and this was statistically significant (P= 0.000). Fall in mean arterial pressure in the Bupivacaine only group was 23.63% (Mean), while in the Bupivacaine plus Ketamine group was 14.53% (Mean). This was statistically significant (P= 0.000). Incidence of bradycardia was statistically lower in the Bupivacaine plus Ketamine group. There is no statistically significant difference in the duration of analgesia in both the groups. Side effects like nausea, vomiting, sedation and nystagmus were more with the Bupivacaine plus Ketamine group. Shivering was noted in 10 patients in the Bupivacaine group, while none of the patients in the Bupivacaine plus Ketamine group had so. CONCLUSION Preservative-free ketamine can be added to Bupivacaine 0.5% (Heavy) for spinal anaesthesia in lower abdominal and lower limb surgeries, which would produce optimal operating conditions with a faster onset of sensory blockade and a better haemodynamic profile. The mild sedation and the local anaesthetic sparing effects can be beneficial.
Authors and Affiliations
Sreekumar V, Veena N
Keywords
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- EP ID EP214074
- DOI 10.14260/Jemds/2017/716
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