KETAMINE AND LIDOCAINE ANESTHESIA FOR SHORT-DURATION NON-CARDIAC SURGERIES: A COMPARATIVE CASE-CONTROLLED STUDY VERSUS FENTANYL-BASED ANESTHESIA
Mohamed Ali Mahmoud, Azza Mahrous Shaffik*, Eman Mohamed SM Elafifi*
Department of Anesthesia & ICU, Faculty of Medicine, Al-Azhar (Assiut branch) and Benha* Universities
Objectives: This study aimed to evaluate the ability of induction and maintenance of anesthesia with ketamine and lidocaine on hemodynamic effects of endotracheal intubation (ETI) and surgical stress in comparison to fentanyl analgesia during open inguinal hernioplasty. Patients & Methods: 80 males were divided into group A received induction by propofol and fentanyl and group B received induction by propofol and boluses of ketamine (0.5 mg/kg) and lidocaine (1 mg/kg). Anesthesia was maintained under non-invasive monitoring of mean arterial pressure (MAP) and heart rate (HR) with sevoflurane. Intraoperative (IO) analgesia was provided as a fentanyl (1 μg/kg) loading dose followed by a fentanyl infusion of 0.3 μg/kg/h for group A and a bolus dose of ketamine (0.5 mg/kg) and lidocaine infusion (2 mg/kg/h) for group B. The study outcomes included the ability of ketamine and lidocaine analgesia to control the reflex MAP changes to ETI and surgical stress. Results: the recorded MAP and HR measures during ETI and surgery showed insignificant differences between both groups. IO hypotension occurred in 23 patients with insignificant differences between both groups. PO pain scores showed insignificant differences between both groups and 22 patients did not require PO analgesia. The duration of PO analgesia was significantly longer in group B. The duration of the PO hospital stay was significantly shorter in group B. Conclusion: induction of anesthesia using a combination of ketamine and lidocaine properly controlled response to ETI and surgery pressor reflexes, prolonged PO duration of analgesia, and spared the opioid use.
December 2020