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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Bupivacaine (0.5%) Versus (0.5%) Bupivacaine with Ketamine (50 mg) for Subarachnoid Block in Lower Abdominal Surgeries: A Randomised Comparative Study
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Bupivacaine (0.5%) Versus (0.5%) Bupivacaine with Ketamine (50 mg) for Subarachnoid Block in Lower Abdominal Surgeries: A Randomised Comparative Study

机译：布比卡因（0.5％）对（0.5％）布比卡因联合氯胺酮（50 mg）用于下腹部手术中蛛网膜下腔阻滞：一项随机对照研究

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Introduction: Spinal anaesthesia is the preferred technique for most of the lower abdominal surgeries nowadays. Currently, Bupivacaine is the most commonly used drug in spinal anaesthesia. A number of adjuvants have been used to improve post-operative analgesia, along with the bupivacaine. Intrathecal ketamine, which is a N-Methyl D-Aspartate (NMDA) blocker prolongs the duration of post-operative analgesia due to inhibition of dorsal horn.Aim: To assess the duration of post-operative analgesia between two groups i.e., bupivacaine alone and bupivacaine with ketamine and also to assess the intraoperative and post-operative haemodynamic stability, onset and duration of sensory as well as motor block, side-effects of injection ketamine when given intrathecally as an adjuvant with injection bupivacaine.Materials and Methods: A prospective, randomised study was conducted in 60 patients with American society of Anaesthesiologist (ASA) Class I and II aged between 20-60 years posted for elective lower abdominal surgeries under subarachnoid block and were randomly selected and divided into two groups of 30 each. Bupivacaine Group B received intrathecal bupivacaine 12.5 mg (2.5 mL)+1.0 mL normal saline (total volume of 3.5 mL) whereas, ketamine Group BK received intrathecal bupivacaine 12.5 mg (2.5 mL)+1 mL (50 mg) Ketamine (total volume of 3.5 mL). Statistical analysis was done by using descriptive and inferential statistics using chi-square test and Student?s t-test.Results: The onset of sensory block was faster in group BK than compared to group B. Duration of sensory block and the time for 1st pain medication was significantly prolonged in Group BK. Haemodynamic parameters were comparatively more stable in Group BK than Group B.Conclusion: Ketamine, when added to bupivacaine intrathecally, decreased onset and prolonged the duration of sensory block. It also prolonged the post-operative analgesia with better haemodynamic stability than bupivacaine alone.
机译：简介：脊柱麻醉是当今大多数下腹部手术的首选技术。目前，布比卡因是脊柱麻醉中最常用的药物。许多辅助剂已与布比卡因一起用于改善术后镇痛效果。鞘内注射氯胺酮是N-甲基D-天门冬氨酸（NMDA）阻滞剂，由于背角受到抑制，延长了术后镇痛的持续时间。目的：评估两组布比卡因单独使用和术后镇痛的持续时间。布比卡因与氯胺酮一起使用，以及评估鞘内注射氯胺酮作为布比卡因注射剂的佐剂时，评估术中和术后血流动力学稳定性，感觉和运动阻滞的发作和持续时间，副作用。材料与方法：前瞻性，在美国麻醉学会（ASA）I级和II级年龄在20至60岁之间的60例患者中进行了随机研究，该患者因蛛网膜下腔阻滞下的选择性下腹部手术而被随机分为两组，每组30人。布比卡因B组接受鞘内注射布比卡因12.5 mg（2.5 mL）+1.0 mL生理盐水（总体积3.5 mL），而氯胺酮BK组接受鞘内注射布比卡因12.5 mg（2.5 mL）+1 mL（50 mg）氯胺酮（总体积3.5 mL）。通过描述性和推论性统计，使用卡方检验和St​​udent's t检验进行统计分析。结果：与B组相比，BK组的感觉阻滞发作更快。 BK组止痛药明显延长。 BK组的血流动力学参数相对稳定。B结论：氯胺酮鞘内添加至布比卡因时，起效减少，并延长了感觉阻滞的持续时间。与单独的布比卡因相比，它还延长了术后镇痛的血液动力学稳定性。

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