Background: Intravenous Regional Anaesthesia (IVRA) is a technically simple and reliable method of providing analgesia to the distal part of limbs. Major limitations of this technique is slow onset of sensory and motor block, tourniquet pain and short duration of post-operative analgesia. Numerous studies have been conducted to find the ideal adjuvant which can modify these limitations. In this study we observed, compared and evaluated the effect of ketamine and midazolam when used as adjuvants to 0.5% lignocaine for IVRA on sensory block onset time, tourniquet pain and postoperative analgesia.
Materials and Methods: A total of 40 patients undergoing implant removal from hand and forearm surgery under IVRA were divided in two groups of 20 each, with 0.5 mg/kg ketamine or 50 microgm/kg midazolam added to 0.5% lignocaine made to 40ml. Time of onset of sensory blockade and tourniquet pain was monitored. Duration of postoperative analgesia and side effects were also noted. Data analyzed using IBM SPSS Statistics 16.0 software and P < 0.05 was considered as statistically significant.
Results: The mean time to onset of sensory block was 3.41 ± 0.54 minutes in the lignocaine - ketamine group and 4.02 ± 0.298 minutes in the lignocaine - midazolam group. The difference was statistically significant with p value 0.017. Even though tourniquet pain onset time and postoperative analgesia was prolonged in lignocaine – ketamine group compared to lignocaine –midazolam, it was not statistically significant. No side effects were observed during the study.
Conclusion: We conclude that adding 0.5 mg/kg ketamine to 0.5 % lignocaine will provide significantly earlier sensory onset of IVRA compared to 50 microgm/ kg midazolam
Impact Factor
2022: 6.012
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