The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Dose-Related Prolongation of Ropivacaine Epidural Anesthesia by Epidural Ketamine

로피바카인 경막외 마취 시 케타민첨가 용량에 따른 마취시간의 연장

  • Joo, Jin Deok (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jeon, Yeon Su (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jin Woo (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • In, Jang Hyeok (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Yong Shin (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kang, Yoo Jin (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dae Woo (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lim, Yong Gul (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Ghi Hyun (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea)
  • 주진덕 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 전연수 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 최진우 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 인장혁 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김용신 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 강유진 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김대우 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 임용걸 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김기현 (가톨릭대학교 의과대학 마취통증의학교실)
  • Received : 2005.03.03
  • Accepted : 2005.06.10
  • Published : 2005.06.30
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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.

Keywords

References

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