EVALUATION OF ANALGESIC EFFICACY AND SAFETY OF EPIDURAL MAGNESIUM SULPHATE, DEXMEDETOMIDINE AND KETAMINE AS ADJUVANTS TO BUPIVACAINE FOR INTRA OPERATIVE ANALGESIA IN EXPLORATORY LAPAROTOMY
Dr. Aatif Shah*, Dr. Kharat Mohd Butt
Background- Postoperative pain relief has always been a cause of concern for patients undergoing exploratory laparotomy. Epidual infusions of local anaesthetics are from times being used for the same. Various additives added to it may supplement the analgesic potency of local anesthetics. Studies to find the ideal additive have always been on the go. Objectives- This study aimed at evaluating intraoperative analgesia after lumbar epidural ketamine, magnesium sulphate or dexmedetomidine associated to 0.25% bupivacaine for exploratory laparotomy. Method- A randomized study was done. The patients undergoing elective exploratory laprotomy were divided into three groups (Group A, Group B, and Group C).
Group A –patients who were to receive magnesium sulphate (n=20)
Group B- patients who were to receive dexmedetomidine (n=20)
Group C-- patients who were to receive ketamine(n=20)
Isoflurane concentration and intraoperative analgesia(using clinical signs) was recorded.
Results- Our study has observed decreased systemic systolic pressure in 60% of Ketamine, 25% of Clonidine and 30% of Dexmedetomidine group patients; heart rate was decreased in 15% of Ketamine and 10% of Dexmedetomidine group patients. Conclusion- The above results help us to conclude that epidural ketamine, dexmedetomidine and magnesium sulphate decrease the requirement of fentanyl and isoflurane inspired concentration in the intraoperative period of exploratory laprotomies.
Keywords: exploratory laparotomy ;epidural; intraoperative analgesia; isoflurane; safety.
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