İşbir, Ahmet Cemil Harput Devlet Hastanesi - Anesteziyoloji ve Reanimasyon Kliniği, Turkey , Mimaroğlu, Caner Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Düger, Cevdet Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kol, İclal Özdemir Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kaygusuz, Kenan Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Öztürk, Hayati Cumhuriyet Üniversitesi - Tıp Fakültesi - Ortopedi ve Travmatoloji Anabilim Dalı, Turkey , Gürsoy, Sinan Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey

The effects of ketamine addition to levobupivacaine and bupivacaine in spinal anesthesia for lower extremity surgery

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Aim. The aim of this study is to investigate the effects of the addition of ketamine to levobupivacaine and bupivacaine for lower extremity surgeries. Methods. The study was performed on 120 patients (ASA I-II), aged between 18 and 60 years. All participants were randomized to four groups consisted of 30 patients. In all participants, 25 G Quincke type spinal needles were inserted to the intrathecal cavity, from L3-L4 or L4-L5. Ten miligrams (mg) 0.5% bupivacaine was administered to Group I, 10 mg 0.5% levobupivacaine was administered to Group II, 10 mg. 0.5% bupivacaine plus 25 mg ketamine was administered to Group III and 10 mg 0.5% levobupivacaine plus ketamine was administered to Group IV. Systolic, diastolic, mean arterial pressure values, heart rates, oxygen saturations (SpO2), sedation scores, duration of surgical procedure, starting times of sensorial and motor blockages, maximum levels of sensorial block, sensorial and motor block times, and postoperative visual analog scale (VAS) scores and analgesic request data of all patients were recorded. Results. There were no differences among four groups regarding age, sex, heart rate, systolic and diastolic arterial pressure or SpO2 (p 0.05). Thesensorial and motor block times were longer and starting times of sensorial and motor blocks wereshorter in the groups given ketamine (p 0.05). There were no differences among the groupsregarding maximum levels of sensorial block (p 0.05). The number of the patients with a sedationscore of 2/3 in Group III and Group IV were more than Group I and II (p 0.05). The VAS scoresat postoperative 2nd and 3rd hours of Group III and IV were significantly lower than those of GroupI and II (p 0.05). The time to first analgesic request of Group III and IV was significantly longerthan that of Group I and II (p 0.05). Conclusion. In conclusion, we suggest that adding ketamineto levobupivacaine and bupivacaine could fasten spinal block and increase sensorial blockagetimes. The side effect of short sedation may help in reducing anxiety feeling in patients during thesurgical operation.

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Spinal anesthesia , levobupivacaine , bupivacaine , ketamine

Cumhuriyet Medical Journal

87