Effects of S(+) ketamine added to bupivacaine for spinal anaesthesia for prostate surgery in elderly patients.
Eur J Anaesthesiol
; 21(3): 193-7, 2004 Mar.
Article
en En
| MEDLINE
| ID: mdl-15055891
ABSTRACT
BACKGROUND AND OBJECTIVE:
Intrathecal ketamine as the sole anaesthetic agent has demonstrated a lack of cardiovascular depression that should be of advantage in an elderly population. S(+) ketamine has three-times the analgesic potency of R(-) ketamine and its antinociceptive effects after intrathecal administration in rats are known. We decided to evaluate the effects of intrathecal S(+) ketamine added to a small dose of spinal bupivacaine in elderly patients undergoing transurethral prostate surgery.METHODS:
Forty males over 60 yr old, scheduled for transurethral prostate resection under spinal anaesthesia, were studied in a prospective, double-blinded, randomized way. Patients were allocated to receive either bupivacaine 10 mg or bupivacaine 7.5 mg combined with S(+) ketamine 0.1 mg kg(-1). Spinal block onset time, maximum sensory level, duration of blockade, haemodynamic variables, postoperative analgesic requirements and adverse events were recorded.RESULTS:
Onset times of motor and sensory block were shorter in the bupivacaine plus S(+) ketamine group. Incomplete motor block of the lower extremities was seen in 80% of the patients in bupivacaine plus S(+) ketamine group. Duration of complete motor block and spinal analgesia was shorter in the bupivacaine plus S(+) ketamine group. There was no significant difference in arterial pressure. Heart rate decreased after spinal anaesthesia in the bupivacaine plus S(+) ketamine group and was significantly lower until the end of anaesthesia. The incidence of adverse effects was not different between groups.CONCLUSIONS:
Intrathecal S(+) ketamine administered with a low dose of bupivacaine provides shorter motor and sensory block onset time, shorter duration of action and less motor blockade in elderly males.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Bupivacaína
/
Antagonistas de Aminoácidos Excitadores
/
Resección Transuretral de la Próstata
/
Ketamina
/
Anestesia Raquidea
/
Anestésicos Locales
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur J Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2004
Tipo del documento:
Article
País de afiliación:
Turquía