Comparison of Post-Operative Analgesic Effects of Intrathecal Dexmeditomidine Versus Intrathecal Ketamine Added to Bupivacaine in Total Knee Replacement Surgeries

Fahad Hasnain; Munim Saeed; Syed Qasim Ali Shah; Muhammad Mohsin Riaz; Waqas Khalil; Muhammad Huzaifa Sharif

doi:10.51253/pafmj.v74i6.9455

Authors

Fahad Hasnain Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Munim Saeed Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Syed Qasim Ali Shah Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Mohsin Riaz Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Waqas Khalil Department of Rehab Medicine, Armed Forces Institute of Rehabilitation Medicine/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Huzaifa Sharif Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.9455

Keywords:

Bupivacaine, Dexmedetomidine, Intrathecal, Ketamine, Total knee replacement

Abstract

Objective: To compare the analgesic efficacy of Dexmedetomidine versus Ketamine when added to intrathecal Bupivacaine in patients undergoing unilateral total knee replacement surgery.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Rawalpindi, Pakistan, from May to Oct 2022.

Methodology: Our study enrolled a total of 80 patients, divided into Dexmedetomidine group (n=40) and Ketamine group (n=40) group using non-probability consecutive sampling. Patients in both groups received 2.5 ml of 0.5% Bupivacaine with Dexmedetomidine group receiving 5 mcg (0.5 ml) of the drug and Ketamine group 0.1 mg/kg of Ketamine in 0.5 ml to a total volume of 3 ml. Data analysis was performed using SPSS 26.0, with significance set at p≤0.05.

Results: Time of onset for sensory block in Dexmedetomidine group was delayed than Ketamine group with mean time of onset 4.34±0.14 minutes versus 3.38±0.10 minutes (p<0.0001). The duration of block was more for Ketamine group with mean time of 326.20±12.67 minutes versus 243.76±2.54 minutes (p<0.0001). When comparing motor blockade, the time of onset to successfully reach Bromage Score 3 was similarly delayed in Dexmedetomidine group with mean time of onset 3.33±0.12 minutes versus 2.36±0.09 minutes (p<0.0001). A similar trend was seen in duration of block with mean time 203.40±1.46 minutes versus 263.01±13.44 minutes (p<0.0001)

Conclusion: Ketamine provided superior analgesia, block onset and duration with less post-operative analgesia requirement.

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