Comparative Study of Ketamine and Fentanyl When Added to Intrathecal Bupivacaine on Sensory and Motor Blockade in Patients Undergoing Total Abdominal Hysterectomy

Abstract

Introduction:- Ketamine and Fentanyl used intrathecally as adjuvant to 0.5% hyperbaric bupivacaine for patients undergoing TAH to shorten the onset of sensory and motor blockade and prolonging the duration of block. \nAims and Objective:-We evaluated onset and duration of sensory and motor blockade and timing of regression of sensory blockade to T 12 and motor blockade to Bromage scale 3. \nMaterial and Methods:-This analytical Comparative Study was conducted in Department of Anaesthesiology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow over a period of eighteen months from 2016 -2018 following approval from institutional ethical committee and written informed patient consent. The sample size of 162 female patient aged 40 to 60 years, belonging to ASA physical status 1 and 2 undergoing TAH were randomly allocated to three groups in double blind manner. Group I Received Inj. Bupivacaine (0.5% Heavy) 3.0ml + Inj. Ketamine (25 mg), Group II Received Inj. Bupivacaine (0.5% Heavy) 3.0 ml + Inj. Fentanyl (25 µgm), Group III (Control Group): Received Inj. Bupivacaine (0.5% Heavy) 3.0 ml + Normal saline 0.5 ml. Onet and Duration of Sensory and Motor Blockade and time taken for regression of sensory level to T12 and motor level to Bromage scale 3 noted. \nResults:- The present study showed that both Ketamine as well as Fentanyl shortened the onset time and prolonged the block duration. However, with respect to onset time, ketamine has shorter onset of blockade than fentanyl. \nConclusion:- Both the modalities independently assured quicker onset and prolonged duration of block, thus suggesting that adjuvant use of either of two could be beneficial.