COVID-19 Update - This is to inform you that the Government of India has announced a complete lockdown in India 22nd March 2020 to 14th April 2020. As a result, our offices will now be closed till 14th April 2020 and all our employees will be working from home. Office telephones will not be answered, and therefore you are requested to direct all your queries related to manuscript submission, review process, publication etc. at below mentioned details. editor@innovativepublication.com, rakesh.its@gmail.com, Mob. 8826373757, 8826859373, 9910947804

Article view: 146

Article download: 35

Indian Journal of Clinical Anaesthesia


Comparative evaluation of dexmedetomidine and ketamine for epidural analgesia in lower limb orthopedic surgeries


Full Text PDF Share on Facebook Share on Twitter


Research Article

Author Details : Malti J Pandya, Ayush Shah*

Volume : 7, Issue : 1, Year : 2020

Article Page : 166-171


Suggest article by email

Abstract

Introduction: The combined spinal epidural anesthesia (CSE) plays a unique role in management of
perioperative analgesia. It is associated with early postoperative mobilization and rehabilitation with
minimally associated pain and discomfort, which is the most desirable feature in modern surgery.We
designed this study for comparative evaluation of dexmedetomidine and ketamine for epidural analgesia
in lower limb orthopedic surgeries in patients operated under CSE.
Materials and Methods: The study included 50 patients divided into two groups (25 each). Group D:
Patient received bolus dose of dexmedetomidine 1 mg/kg after spinal anesthesia followed by bupivacaine
0.125% with dexmedetomidine 1 mg/ml epidurally using 240 ml elastomeric pump at 5ml/ hr till 48 hours.
Group K: Patient received bolus dose of ketamine 0.5 mg/kg after spinal anesthesia followed bupivacaine
0.125% with ketamine 0.5mg/ml epidurally using elastomeric pump at 5ml/hr till 48 hours.
Results: There was no significant difference between the two groups (p>0.05) in terms of highest sensory
level achieved and time for complete motor block. The patients in both the groups were hemodynamicaly
stable throughout the study. The duration of analgesia was longer with dexmedetomidine however, none
of the patients in both the groups required rescue analgesic. The time to regression of sensory level to L5
in Group D was found to be 594 63.04 minutes as compared to 362.4 45.76 minutes in Group K (p
< 0> minutes whereas, in Group K it was 303.6 36.04 minutes (p < 0> vomiting and other side effects were comparable.
Conclusion: We conclude that continuous epidural infusion with dexmedetomidine and ketamine
effectively reduced the postoperative rescue analgesics requirements and provided good patient satisfaction
in patients undergoing lower limb orthopedic surgery.

Keywords: Dexmedetomidine, Ketamine, Epidural infusion.

Doi : 10.18231/j.ijca.2020.029

How to cite : Pandya M J, Shah A, Comparative evaluation of dexmedetomidine and ketamine for epidural analgesia in lower limb orthopedic surgeries. Indian J Clin Anaesth 2020;7(1):166-171

Copyright © 2020 by author(s) and Indian J Clin Anaesth. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (creativecommons.org)