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Abstract

ABSTRACT: BACKGROUND: Ketamine shows beside its general anesthetic effect, a local anesthetic - like action; that is due to blocking of Na+ channels mainly with other proposed mechanisms. OBJECTIVE: Comparison of ketamine local anesthetic action with that of bupivacaine in neuraxial blockage (spinal anesthesia) was done. PATIENTS AND METHODS: Hundred patients were scheduled according to American Society of Anesthesiologists (ASA) physical status classification I-II for elective inguinal hernia surgery under spinal anaesthesia, divided into 2 equal groups, the first group received 2 ml (0.5%) bupivacaine, second group received 2 ml [75 mg preservative free Ketamine (1.5 ml) mixed with 0.5 ml, 30%dextrose], comparison in the onset, duration of the sensory block and the central sedative effect between the two groups was done. RESULTS: Group II patients who received ketamine intrathecally demonstrated faster onset of block with longer duration of analgesia, 30% of them appeared sedated owing to the central sedative effect. CONCLUSION: As a new look to an old drug; ketamine can be used as a pure local anesthetic for spinal anesthesia with the advantage of longer period of analgesia and faster onset as compared with bupivacaine. Ketamine group appeared more hemodynamically stable.

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