2005, Number 1
Rev Mex Anest 2005; 28 (1)
Postoperative epidural analgesia: Ketamine plus bupivacaine vs. bupivacaine alone in hip and femur surgery
Rivera-Ordóñez A, Rivera-Flores J
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ABSTRACTThe purpose of this study was to determine if epidural ketamine combined with a local anesthetic provides better postoperative anesthesia in hip and femur surgery. Fifty patients admitted to Balbuena General Hospital, ages 18 to 60 and ASA I-II, were enrolled the study. Once in the operating room, they were randomized to two groups, 25 patients each. Type I monitoring (cardioscope, sphygmomanometer and pulse oximeter) was used. An epidural catheter was inserted in both groups of patients for intraoperative anesthetic management, later used for postoperative analgesia. Upon termination of surgery, patients in Group 1 were given bupivacaine 20 mg in 10 ml saline solution; patients in Group 2 received ketamine, 200 μg/kg + bupivacaine 20 mg in 10 ml saline solution. Blood pressure, heart rate, respiratory rate, degree of motor blockade, VAS and side effects were monitored at 15 and 30 minutes and at 1, 2, 4, 8, 16 and 24 hours postoperatively. Results showed no statistically significant differences in vital signs. In Group 1, the VAS score at 4 hours was 5.45 ± 1.85; in Group 2 it was 2.19 ± 1.69. Ketamine combined with a local anesthetic provided better quality and longer lasting postoperative analgesia, with no adverse effects.