Intrathecal Ketamine Versus Bupivacaine for Inguinal Hernia Surgery
Iraqi Postgraduate Medical Journal,
2013, Volume 12, Issue 4, Pages 477-481
Ketamine shows beside its general anesthetic effect, a local anesthetic - like action; that is due to blocking of Na+ channels mainly with other proposed mechanisms.
Comparison of ketamine local anesthetic action with that of bupivacaine in neuraxial blockage (spinal anesthesia) was done.
PATIENTS AND METHODS:
Hundred patients were scheduled according to American Society of Anesthesiologists (ASA) physical status classification I-II for elective inguinal hernia surgery under spinal anaesthesia, divided into 2 equal groups, the first group received 2 ml (0.5%) bupivacaine, second group received 2 ml [75 mg preservative free Ketamine (1.5 ml) mixed with 0.5 ml, 30%dextrose], comparison in the onset, duration of the sensory block and the central sedative effect between the two groups was done.
Group II patients who received ketamine intrathecally demonstrated faster onset of block with longer duration of analgesia, 30% of them appeared sedated owing to the central sedative effect.
As a new look to an old drug; ketamine can be used as a pure local anesthetic for spinal anesthesia with the advantage of longer period of analgesia and faster onset as compared with bupivacaine. Ketamine group appeared more hemodynamically stable.
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