Volume : 8, Issue : 3, March - 2019

POST OPERATIVE ANALGESIC EFFECTS WITH LOW DOSE OF INTRAVENOUS KETAMINE IN LOWER LIMB BELOW KNEE ORTHOPAEDIC SURGERIES DURING SPINAL ANESTHESIA- A RANDOMIZED CLINICAL TRIAL

Dr. Muthushenbagam, Dr. Loretta Raj

Abstract :

Objective: The aim of our study is to find the effect of low-dose intravenous ketamine on postoperative pain and the need for supplemental analgesics following lower limb below knee orthopaedic surgeries under spinal anesthesia using heavy bupivacaine Materials and methods: After ethical committee approval and written informed consent, 60 patients of age group 20 to 45 years of both sex and ASA I to II undergoing surgeries for below knee orthopaedic procedures were randomly allocated into two groups of 30 patients each. After administration of spinal anaesthesia with 3cc of 0.5% heavy bupivacaine in both group, Group K receives ketamine (0.25 mg/kg) with 1 mg midazolam & Group P recieves Normal saline with 1 mg midazolam. Patient with failed spinal are excluded from the study. The Numerical rating pain scale will be compared between 2 groups at the time intervals 0,1,2,3,4,5,6,7,8,12. Primary outcome duration of analgesia & secondary outcome – Total doses of rescue analgesic requirements postoperatively. RESULTS: Duration of analgesia was significantly higher in ketamine group (380.2 ± 48.2 min) compared to placebo group (144.4 ± 16 min). (P-value <0.001) Total analgesic dose was significantly lower in ketamine group (112 ± 33mg) compared to placebo (212 ± 33mg). (P-value <0.001) Conclusion: We conclude that administration of low doses of ketamine after spinal anesthesia prolong the duration of analgesia and reduces the total doses of rescue analgesic requirements postoperatively