OLD BUT NOT FORGOTTEN: INTRAVEINOUS KETAMINE HYDROCHLORIDE FOR SHORT SURGICAL PROCEDURES

Dr. Hina Bashir, Dr. Syed Rayees Qadri, Dr. Anjum Shamim*, Dr. Nusrat Jehan, Dr. Mubasher Bhat,
Dr. Anka Amin and Dr. Javed Naqashbandi

ABSTRACT

Background: Ketamine is still considered a valuable drug. A drug with special properties that make it the only agent that presently serves as an anesthetic, sedative, amnesic and analgesic. Although it is recently sometwhat forgotten, once was regarded as complete anesthetic drug. Water soluble, stable and non-irritant when administered intravenously, Ketamine has rapid onset and provides acceptable anaesthesia, minimal depression of cardiovascular and respiratory system, rapid degradation to inactive non-t oxic metabolites and rapid and smooth emergence with minimal side effects with no hypersensitivity reaction. These properties make Ketamine useful for total intravenous (IV) anaesthesia. In selected patients where intense analgesia is needed without any muscular relaxation, Ketamine comes almost to the ideal. Aim: To evaluate the efficacy of administration of Ketamine for total intravenous (IV) anaesthesia in short term procedures. Methods: After taking informed consent, 60 patients of (ASA) physical status I-II of both sexes, aged between 19 and 70 years, categorized into three groups, Group-A ( n=20) for general surgery, Group-B (n=20) for orthopedic surgery, Group-C (n=20) for Gynecological surgery, for various short surgical procedures. Note was being made of quality of anesthesia, analgesia and any complications. Results: It was concluded by evaluation and clinical trial that Ketamine can be used as a sole anaesthetic agent with minimum adverse effects and maximum safety. Regarding the intraoperative quality of anesthesia, 17patient in group A had an excellent and 3 patients had good anesthesia. In group B, 18 patients had excellent and 2 patients had good anaesthesia. In group C 18 patients had an excellent and 2 patients had good anesthesia. The statistical difference between the groups was not significant. There was a insignificant difference regarding time to rescue analgesia and the total dose of rescue analgesics required during the postoperative 24 hours. Conclusion: Ketamine can be used as a sole anaesthetic agent with considerable amount of success in most of the short surgical procedures. It has the advantage of rapid and smooth onset of action, minimal depression of respiratory system and intense analgesia during intra-operative and post-operative period.

Keywords: Ketamine, sedative, amnesic and analgesic.