ASSESMENT OF DURATION OF ANALGESIA BY COMPARING INTRATHECAL BUPIVACAINE WITH KETAMINE AND HYPERBARIC BUPIVACAINE FOR CAESAREAN SECTION PATIENTS

OBJECTIVE: Spinal Anesthesia is the most preferred technique of anesthesia for lower segment caesarean section which provides effective pain relief during intraoperative and initial postoperative period. Various intrathecal adjuvant for postoperative pain relief have been tried which provide suboptimal analgesia and various side effects on maternal and fetus. We planned to assess the duration of analgesia by comparing intrathecal hyperbaric bupivacaine with preservative free ketamine and hyperbaric bupivacaine alone in parturient undergoing caesarean section. METHODS: A prospective, randomized, controlled study was conducted on 100 pregnant patients belonging to ASA I & II scheduled for LSCS under spinal anesthesia. Study comprised of two groups of 50 patients each. The first group received 2 ml of Hyperbaric Bupivacaine 0.5%+25 mg Preservative free Ketamine while group II received 2 ml of Hyperbaric Bupivacaine 0.5%. RESULTS: The mean duration of postoperative analgesia was160 +/- 0.6minutes in group I and 120 +/- 0.7minutes in group II, P value < 0.001. Incidence of hypotension and bradycardia was less in group I as compared to that of group II. Apgar score was statistically insignificant in both the groups. CONCLUSIONS: Addition of 25mg preservative free ketamine to hyperbaric bupivacaine in spinal anesthesia for LSCS significantly prolongs the duration of postoperative analgesia with better intraoperative hemodynamically stability and without any adverse effect on neonates.