Epidural block with Bupivacaine with or without Ketamine: A comparative assessment of clinical efficacy

Abstract

Background:An epidural nerve block is an anaesthetic procedure performed by injecting anaesthetic medication into the epidural space useful for carry on complicated and long-running surgeries, useful for diagnostic procedures, acute pain therapy or to treat chronic pain syndromes. Objective: To compare the clinical efficacy of Bupivacaine with or without Ketamine for epidural block. Methods:A total of 80 patients fulfilling as per the American Society of Anesthesiologists I and II of either sex aged between 40-70 yrs were considered for the study. Patients were treated with Bupivacaine alone or in combination with Ketamine prior to surgery and clinical efficacy was evaluated by assessing the time of onset of sensory block, time of onset of maximum motor block and duration of analgesia. Motor block was evaluated by Bromage scale. Results:In Bupivacaine alone group mean onset of anaesthesia was significantly less in the patients receiving combination of Bupivacaine and Ketamine (P<0.05). Onset of maximum motor block was also smaller and for longer duration in combination group. In addition, duration of analgesia was also increased by 1 hr in combination group. Conclusion:It is concluded that addition of Ketamine 0.5 mg/kg to caudal Bupivacaine 0.25% in a dose of 1 ml/kg significantly prolonged the postoperative analgesia compared with administration of caudal Bupivacaine 0.25% in a dose of 1 ml/kg alone.
Keywords: Epidural, block, Bupivacaine, Ketamine