Dose-Related Prolongation of Ropivacaine Epidural Anesthesia by Epidural Ketamine.
- Author:
Jin Deok JOO
1
;
Yeon Su JEON
;
Jin Woo CHOI
;
Jang Hyeok IN
;
Yong Shin KIM
;
Yoo Jin KANG
;
Dae Woo KIM
;
Yong Gul LIM
;
Ghi Hyun KIM
Author Information
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords: epidural ketamine; sodium channel; transcutaneous electric stimulation (TES); two (four) segments regression time
- MeSH: Anesthesia, Epidural*; Anesthetics; Anesthetics, Local; Binding Sites; Bradycardia; Humans; Hypotension; Ketamine*; Sodium Channels; Transcutaneous Electric Nerve Stimulation
- From:The Korean Journal of Pain 2005;18(1):39-42
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND: Besides its general anesthetic effect, ketamine interacts with sodium channels in a local anesthetic-like fashion, including the sharing of binding sites with those commonly used by clinical local anesthetics. This study evaluated the dose related effects of ketamine during epidural anesthesia with 0.5% ropivacaine. METHODS: Sixty ASA physical status I-II patients, scheduled for minor elective surgery under epidural anesthesia using 0.5% ropivacaine, were randomly divided into three groups (n = 20 each). The patients initially received either 0.5% ropivacaine (group 1), ketamine (0.1 mg/kg) in addition to the epidural 0.5% ropivacaine (group 2) or ketamine (0.2 mg/kg) in addition to the epidural 0.5% ropivacaine (group 3). The regression of sensory block was assessed by transcutaneous electric stimulation (TES), equivalent to a surgical incision. Motor block was assessed using the Modified Bromage's scale. Episodes of bradycardia, hypotension and sedation were also recorded. RESULTS: There were no significant differences among the three groups in the maximal levels of sensory block or the times taken for these levels to be reached. The mean times for the block to regress to two and four segments below the maximal level were significantly prolonged by epidural ketamine. CONCLUSIONS: Epidural ketamine prolongs the duration of ropivacaine epidural anesthesia. These results suggest that ketamine has local anesthetic-like actions.
