A study to evaluate the effect of subcutaneous infiltration of ketamine at incisional site on post operative analgesia in patients undergoing abdominal hysterectomy under spinal anaesthesia
Background: Postoperative pain is often perceived by patient as natural consequences of surgery. If poorly treated it triggers neuroendocrine stress response which may increase morbidity and mortality. Ketamine acts as non-competitive antagonist at NMDA receptors having local analgesic effect. If given subcutaneously the side effects are significantly lower. Aims and Objectives: To evaluate the analgesic effects of subcutaneous infiltration of ketamine at incisional site in elective abdominal hysterectomy under spinal anaesthesia. Materials and Methods: Fifty patients of ASA physical status 1 & 2 aged 35-60 years undergoing abdominal hysterectomy were allocated into two groups as group K and group C, using computer generated random number list each consisting 25 patients (n=25), group K received ketamine 0.5mg/kg subcutaneously and group C 0.9% normal saline subcutaneously in surgical wound site post operatively. Patients were monitored at 0 minutes, 30 minutes,1,2,4,6,8,12,16,20,24 hours interval for changes in HR, BP, SPO2,VAS. Also side effects if any are noted. Time for the first request for analgesia and total amount of rescue analgesic consumed in 24 hours noted and compared between both groups statistically. Results: The time for first request for analgesia in group C was 149.60+7.27 minutes whereas it was longer in group K 245.80+15.27minutes (P<0.001), the mean VAS scores in group K at 2,4,6,8, and 12 hours was less compared to group C recorded during same time interval, which is statistically significant and the total amount of rescue analgesia consumed during 24 hours in group C was 86.0+30.69 whereas in group K it was 46+24.66.significantly lower in group K compared to group C(P<0.001). Conclusion: Patient who were given ketamine subcutaneously at incision site postoperatively had lower pain intensity and less analgesic consumption than patients who were given placebo without increase in the risk of complications
