Comparative evaluation of the effect of intrathecal ketamine and fentanyl added to bupivacaine in elective hernia repair surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 6, Issue 3
Abstract
Background: Addition of adjuvants in spinal anaesthesia spares the local anaesthetic dose and produces good postoperative analgesia. Aim: To compare the duration of prolongation of postoperative analgesia between Ketamine and Fentanyl when added to hyperbaric bupivacaine for elective inguinal hernia surgeries. Material and Methods: This is a non randomised prospective triple arm single blind comparative study including 90 patients undergoing elective inguinal hernia repair surgery. Patients satisfying inclusion criteria, with written consent were divided into three groups : Group B receiving a spinal drug volume of 3ml hyperbaric 0.5 % bupivacaine with 0.5 ml normal saline, Group F receiving a spinal drug volume 3ml hyperbaric 0.5 % bupivacaine with 25 mcg fentanyl (0.5ml), Group K received a spinal volume 3ml hyperbaric 0.5% bupivacaine with 25 mg preservative free Ketamine (0.5ml). The time of onset of sensory and motor blockade, duration of sensory and motor blockade, time of requirement of first dose analgesic, total analgesic requirement were recorded apart from the vital hemodynamic and saturation monitoring. Requirement for ephedrine and incidence of adverse effects were also recorded. Results: Addition of Ketamine and Fentanyl to Bupivacaine prolongs the onset of sensory and motor blockade; prolongation is greater with fentanyl than with ketamine. Ketamine and Fentanyl when added to hyperbaric bupivacaine prolongs the duration of motor and sensory blockade; prolongation being greater with ketamine than fentanyl. The total ephedrine requirement and the total analgesic requirement in the first 24 hours period was significantly lower in the Ketamine group compared to Fentanyl or control group. Conclusion: Intrathecal Ketamine is a better adjuvant to hyperbaric bupivacaine than intrathecal fentanyl in prolonging the duration of blockade and postoperative analgesia in patients undergoing inguinal hernia repair under spinal anaesthesia.
Authors and Affiliations
T Murugan, N Sathyan, Anju Daniel Prasath, Subha 4
Keywords
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