IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-3-18496 Original Research Paper Comparison of Ketamine and Magnesium As Adjuvant to Bupivacaine In Epidural Anaesthesia For Abdominal Surgery. Neel Kamal Mishra Dr. Dr Haidar Abbas Dr. Dr Bhavya Naithani Dr. March 2019 8 3 01 02 ABSTRACT

BACKGROUND: Neuraxial blocks provide anaesthesia along with post operative pain relief. Various adjuvants have been added to local anaesthetic drugs in epidural anaesthesia to improve outcome and reduce side effects related to toxicity of local anaesthetics .The aim of the study is to compare the effects of magnesium sulphate versus preservative–free ketamine as an adjuvant to epidural bupivacaine in abdominal surgeries. MATERIALS AND METHODS: After obtaining informed consent, the patients were divided into 3 groups of 30 each ,Group I: bupivacaine 0.5% (19 ml) + saline 0.9% (1 ml), Group II: bupivacaine 0.5% (19 ml) + ketamine 50 mg (1 ml).,Group III: bupivacaine 0.5% (19 ml) + magnesium sulphate 75 mg (1 ml). RESULTS. Time taken to T6 block, the time from the epidural to surgical incision and time for two segment regression was significantly lower in group II as compared to groups I and III with a p value of 0 .001,0.001,0.006 respectively. Time of first epidural top up was significantly higher in group II than group I and III with p–value=0.003. . VAS( mean) was lowest in the group II and highest in the group I whereas VAS of group III was in between these two values, being statistically significant at 90 min with a p–value of 0.01. The hypotension was found in 83.3% of Group I, 26.7% in Group II and 60% in Group III and the difference was statistically significant (p=0.001). CONCLUSION Our findings establish ketamine as a predictable and safe adjuvant to epidural bupivacaine for rapid and prolonged anaethesia with stable hemodynamic profile, better perioperative VAS scores, satisfactory surgical conditions and fewer side effects.