The Effect of Ketamine as Adjuvant in Ultrasonic Guided Supraclavicular Brachial Plexus Block

Abstract

Background: many of the surgical procedures are done daily all over the world. Patients get benefit from the amazing advances in both surgical and anesthesia techniques. However, despite the progress in understanding the physiology of pain and the pharmaceutical properties of painkillers, many patients are still suffering from severe postoperative pain after surgery. Objective: The aim of the current study was to determine the effect of the addition of 25 µg/kg body weight ketamine to 0.5% bupivacaine supra-clavicular brachial plexus block on quality of block, the time of onset and postoperative analgesia time. Patients and Methods: it is a prospective double blinded controlled study that was carried out on 150 patients ASA I – II, aged 18-50 years with different upper limb surgeries of the forearm and the hand in Assiut and Al-Azhar University Hospitals. Results: ketamine was more effective with a mean complete sensory block onset of 11.93±2.95 minute in the ketamine group compared to12.60±3.00 minutes in the control groups. The study also showed that ketamine hastened the onset of complete motor block, with a mean complete motor block onset of 17.33±3.79 minute in the ketamine group compared to 19.67±4.45 minutes in the control group. As regard analgesia duration, the present study showed that ketamine group prolonged the analgesia duration. Conclusion: It could be concluded that addition of (25 µg/kg) ketamine to bupivacaine improves onset of the block, postoperative pain-free time (VAS) and reduces the consumption of postoperative analgesics in patients undergoing different upper limb surgeries of the forearm and the hand.