EFFECTS OF PREINCISIONAL ANALGESIA WITH SURGICAL SITE INFILTRATION WITH KETAMINE OR LEVOBUPIVACAINE IN PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY UNDER GENERAL ANAESTHESIA; A RANDOMISED DOUBLE BLIND STUDY

Dr. Faiza Ahmed Talukdar, Dr. Pronoy Saikia

Abstract


 Objectives

. This study was aimed at comparing the analgesic effects of local wound infiltration preincisionally with Ketamine or Levobupivacaine in elective total abdominal hysterectomy cases done under general anaesthesia.

Methods

This randomized, double blinded, group allocation concealed study of patients was carried out after ethical committee clearance. Eighty patients scheduled for total abdominal hysterectomy, were assigned randomly into two groups to preoperatively receive local subcutaneous wound infiltration with either 20 ml of 2mg/kg  Ketamine (Group K) or 20 ml of 0.25% Levobupivacaine  (Group L) along the surgical incision 15 minutes before incision. Postoperative pain was assessed using Visual Analogue Scale at predefined time points post operatively. Duration of analgesia and amount of rescue analgesic requirement was evaluated.

Results

The demographic parameters and the duration of surgery were comparable. VAS scores decreased significantly in Group K at 8, 12 and 24 hours post operatively compared to Group L. First request for rescue analgesic was significantly delayed in group K ( 165.45 ± 9.38 vs 133.07 ± 8.00 mins, p= <0.001) and the total amount of rescue analgesic consumption in 24 hours postoperatively was significantly  less in group K ( 128.57 ± 45.83  vs 155 ± 50.38 mg, p= 0.02).

Conclusion

Surgical site infiltration with Ketamine provides better postoperative analgesia in lower abdominal surgeries compared to Levobupivacaine without any significant changes in haemodynamics or associated side effects.


Keywords


analgesic, Levobupivacaine, hysterectomy

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