No enhancement of sensory and motor blockade by ketamine added to ropivacaine interscalene brachial plexus blockade

Il Ok Lee, Woo Kyung Kim, Myounghoon Kong, Mi Kyoung Lee, Nan Sook Kim, Young Seok Choi, Sang Ho Lim

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. Methods: Sixty adults scheduled for forearm or hand surgery under the interscalene brachial plexus block were prospectively randomized to receive one of the solutions of the study. Group P received 0.5% ropivacaine 30ml, group K received 0.5% ropivacaine 30ml with 30mg ketamine, and group C received 0.5% ropivacaine with 30mg ketamine i.v. Loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the C4-7 sensory dermatomes were assessed at 1-min intervals. Adverse-effects were assessed every 5min. The duration of the sensory and motor blocks was assessed after operation. Adverse-effects were also recorded. Results: The onset time of sensory or motor blockade and the duration of sensory or motor blockade were similar in all groups. Adverse-effects occurred in 44% of patients in group K and 94% of group C. Conclusion: This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.

Original languageEnglish
Pages (from-to)821-826
Number of pages6
JournalActa Anaesthesiologica Scandinavica
Volume46
Issue number7
DOIs
Publication statusPublished - 2002 Jan 1

Fingerprint

Ketamine
Local Anesthetics
Hand
Incidence
Elbow
Wrist
Forearm
Analgesia
Analgesics
Anesthetics
Brachial Plexus Block
ropivacaine

Keywords

  • Anesthesia
  • Interscalene brachial plexus
  • Ketamine
  • Local anesthetics
  • Regional
  • Ropivacaine

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

No enhancement of sensory and motor blockade by ketamine added to ropivacaine interscalene brachial plexus blockade. / Lee, Il Ok; Kim, Woo Kyung; Kong, Myounghoon; Lee, Mi Kyoung; Kim, Nan Sook; Choi, Young Seok; Lim, Sang Ho.

In: Acta Anaesthesiologica Scandinavica, Vol. 46, No. 7, 01.01.2002, p. 821-826.

Research output: Contribution to journalArticle

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abstract = "Background: Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. Methods: Sixty adults scheduled for forearm or hand surgery under the interscalene brachial plexus block were prospectively randomized to receive one of the solutions of the study. Group P received 0.5{\%} ropivacaine 30ml, group K received 0.5{\%} ropivacaine 30ml with 30mg ketamine, and group C received 0.5{\%} ropivacaine with 30mg ketamine i.v. Loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the C4-7 sensory dermatomes were assessed at 1-min intervals. Adverse-effects were assessed every 5min. The duration of the sensory and motor blocks was assessed after operation. Adverse-effects were also recorded. Results: The onset time of sensory or motor blockade and the duration of sensory or motor blockade were similar in all groups. Adverse-effects occurred in 44{\%} of patients in group K and 94{\%} of group C. Conclusion: This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.",
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AU - Kim, Nan Sook

AU - Choi, Young Seok

AU - Lim, Sang Ho

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N2 - Background: Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. Methods: Sixty adults scheduled for forearm or hand surgery under the interscalene brachial plexus block were prospectively randomized to receive one of the solutions of the study. Group P received 0.5% ropivacaine 30ml, group K received 0.5% ropivacaine 30ml with 30mg ketamine, and group C received 0.5% ropivacaine with 30mg ketamine i.v. Loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the C4-7 sensory dermatomes were assessed at 1-min intervals. Adverse-effects were assessed every 5min. The duration of the sensory and motor blocks was assessed after operation. Adverse-effects were also recorded. Results: The onset time of sensory or motor blockade and the duration of sensory or motor blockade were similar in all groups. Adverse-effects occurred in 44% of patients in group K and 94% of group C. Conclusion: This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.

AB - Background: Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. Methods: Sixty adults scheduled for forearm or hand surgery under the interscalene brachial plexus block were prospectively randomized to receive one of the solutions of the study. Group P received 0.5% ropivacaine 30ml, group K received 0.5% ropivacaine 30ml with 30mg ketamine, and group C received 0.5% ropivacaine with 30mg ketamine i.v. Loss of shoulder abduction, elbow flexion, wrist flexion and loss of pinprick in the C4-7 sensory dermatomes were assessed at 1-min intervals. Adverse-effects were assessed every 5min. The duration of the sensory and motor blocks was assessed after operation. Adverse-effects were also recorded. Results: The onset time of sensory or motor blockade and the duration of sensory or motor blockade were similar in all groups. Adverse-effects occurred in 44% of patients in group K and 94% of group C. Conclusion: This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.

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