A COMPARITIVE STUDY OF PLAIN LIGNOCAINE AND LIGNOCAINE WITH KETAMINE FOR INTRAVENOUS REGIONAL ANAESTHESIA (IVRA) FOR UPPER LIMB SURGERIES

Dr. PETLA RAMA KRISHNA; Dr. C.Surya Narayana

Volume : V, Issue : V, May - 2015

A COMPARITIVE STUDY OF PLAIN LIGNOCAINE AND LIGNOCAINE WITH KETAMINE FOR INTRAVENOUS REGIONAL ANAESTHESIA (IVRA) FOR UPPER LIMB SURGERIES

Dr. Petla Rama Krishna, Dr. C. Surya Narayana

Abstract :

BACK GROUND : IVRA was one of the most commonly performed technique,however the drawback was rapid onset of pain after tourniquet deflation.In the study , we evaluated the effect of ketamine , an IV induction agent added in sub anaesthetic doses as adjuvant to lignocaine in IVRA to improve analgesia and impair tourniquet pain . METHODS: 50 patients of age above 18 years undergoing hand and forearm surgery , were divided into two groups. Both groups received IVRA with plain lignocaine (3mg/kg) diluted with saline to a total volume of 40ml.Group L received only lignocaine, group K received lignocaine and ketamine (0.5mg/kg).Sensory and motor block onset time, their recovery time , tourniquet pain and rescue analgesia were assessed during operation.After tourniquet deflation visual analogue scores at 1,2,4,6,12 and 24 hours ,total analgesic consumption in first 24 hours and side effects were noted. RESULTS: Onset of motor block was shorter and recovery of motor and sensory block were significantly longer in group K (p<0.05).Intraoperative VAS scores , intraoperative fentanyl consumption and number of patients who required fentanyl were significantly lower in group K(p<0.05). Post operative VAS scores were similar among groups,however total amount of diclofenac used was less in group K(p<0.05). CONCLUSION: Addition of Ketamine to IVRA with lignocaine decreased tourniquet pain and post operative analgesic consumption