Document Detail


No enhancement of sensory and motor blockade by ketamine added to ropivacaine interscalene brachial plexus blockade.
MedLine Citation:
PMID:  12139537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. METHODS: Sixty adults scheduled for forearm or hand surgery under the interscalene brachial plexus block were prospectively randomized to receive one of the solutions of the study. Group P received 0.5% ropivacaine 30 ml, group K received 0.5% ropivacaine 30 ml with 30 mg ketamine, and group C received 0.5% ropivacaine with 30 mg ketamine i.v. Loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the C4-7 sensory dermatomes were assessed at 1-min intervals. Adverse-effects were assessed every 5 min. The duration of the sensory and motor blocks was assessed after operation. Adverse-effects were also recorded. RESULTS: The onset time of sensory or motor blockade and the duration of sensory or motor blockade were similar in all groups. Adverse-effects occurred in 44% of patients in group K and 94% of group C. CONCLUSION: This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.
Authors:
Il-Ok Lee; Woo-Kyung Kim; Myung-Hoon Kong; Mi-Kyung Lee; Nan-Sook Kim; Young-Seok Choi; Sang-Ho Lim
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  46     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-25     Completed Date:  2002-10-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  821-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Woo-Kyung Kim, College of Medicine, Korea University, Korea University Guro Hospital, Seoul, South Korea. iloklee@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Amides / administration & dosage*,  adverse effects
Analgesics / administration & dosage*,  adverse effects
Anesthetics, Combined / administration & dosage*
Anesthetics, Local / administration & dosage*,  adverse effects
Brachial Plexus*
Double-Blind Method
Female
Humans
Ketamine / administration & dosage*,  adverse effects
Male
Nerve Block* / adverse effects
Pain, Postoperative / prevention & control*
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Amides; 0/Analgesics; 0/Anesthetics, Combined; 0/Anesthetics, Local; 6740-88-1/Ketamine; 84057-95-4/ropivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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