Effects of ketamine hydrochloride (preservative free) and fentanyl citrate added to low dose hyperbaric bupivacaine for sub-arachnoid block in lower uterine caesarian section a comperative study

Background Caesarian section is one of the most common operations Now a days for delivery of baby sub-arachnoid block is the better choice. World wide Commonly used bupivacaine with fentanile. Objective The present study was designed to observe the effects of intrathecal ketamine hydrochloride with bupivacaine+complne bupivacaine with fentanyl to observe quality of block eioth duration block during caesarian section. Methods Ninety ASA 1 parturients scheduled for elective caesarian section were randomly selected. There are thirty patients in each group. The base line haemodynamic parameters, heart rate, blood pressure respiratory rate S p O 2 and indication of operation were recorded The control group BN (n = 30) received 1.75 ml of 0.5% hyperbaric bupivacaine plus 0.5 ml normal saline intrathecally. While the study group, fentanyl group BF (n = 30) received 1.75 ml of 0.5% hyperbaric bupivacaine plus 0.5 ml (25 mg) injection fentanyl, BK received 1.75 ml of 0.75% hyperbaric bupivacaine plus 0.5 ml (25 mg) of ketamine hydrochloride. Results Duration and quality of sensory and motor block, post-operative analgesia, haemodynamic changes and sedation levels were assessed. There was no significant difference in duration of motor blockade in three groups. Quality of analgesia, sensory block was significant (P<0.05) in BK and BF group than BN group. The quality of block was excellent throughout the surgical procedure in 80% BK group 60% in BF group and 53.3% in control (BN) group. Incidence of hypotension was less in group BF (26.6%) and BK (20%) than group BN (40%). Ketamine had an upper level of sensory block than fentanyl. Conclusion Injection ketamine 25 mg can be used as an adjunct to low dose spinal bupivacaine during caesarian. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19802 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 53-59