Background& Aims: To compare the analgesic efficacy of ketamine and fentanyl added to intrathecal hyperbaric bupivacaine in patients undergoing elective abdominal hysterectomy.

Methods: Seventy–two patients of ASA grade I/II, 40–60 years old were recruited in a prospective double–blinded, randomized comparative study. Spinal anaesthesia was performed in group F using hyperbaric 0.5% bupivacaine 15mg combined with 25 µg fentanyl and in group K using hyperbaric 0.5% bupivacaine 15mg combined with 25 mg ketamine. The onset time and duration of sensory and motor blockade, total duration of analgesia, and the incidence of adverse effects were recorded.

Results: The onset of sensory and motor block was significantly faster in group K (2.15±0.44 min&1.24±0.44 min) as compared to group F (2.83±0.44 min& 1.81±0.46 min). Duration of sensory and motor block was longer in group F (96.97±8.20 min & 131.33±10.82min)than in group K (88.58±5.91min& 120.69±6.61min). Mean duration of analgesia was 159.92±11.19 min and151.58±8.10min in group F and group K respectively.

Conclusion: Addition of ketamine or fentanyl to spinal bupivacaine were equally effective in pain control after abdominal hysterectomy.