ABSTRACT
Introduction: Postoperative pain management remains veryimportant in patient’s management to ensure a better qualityof life. Unfortunately, adequate postoperative analgesiais achieved in a very less number of patients. Delayedpostoperative mobilization because of pain reduces quality oflife and delays return to normal daily activities. Preemptiveanalgesia is reported to inhibit the persistence of postoperativepain after surgery. The aim of this study was to assess theanalgesic effectiveness of preincisional infiltration of ketaminefollowing elective open cholecystectomy and pyelolithotomysurgery as compared to 0.25% bupivacaine.Material and methods: In this study, 60 patients, age (16 –50yrs) ASA grade I and II are posted for open cholecystectomyand pyelolithotomy surgery, randomly assigned with informedconsent, into 2 groups (n=30),as; Group K: Receivedsubcutaneous infiltration of 10 ml containing ketamine 2mg/kg. Group B: Received subcutaneous infiltration of 10ml 0.25% of bupivacaine, Skin infiltration was given alongthe incision 5 min before incision. Postoperative pain wasassessed using visual analogue scale (VAS) at rest and withevaluation of additional opioid analgesic requirements.Results: Results will be analysed by using theindependent‑sample Student’s t‑test or Mann–Whitney test fornumerical variables and P< 0.005 will be considered significant.We can conclude that ketamine appears to be a promisingpreemptive analgesic through surgical site infiltration. VASscore in ketamine group was significantly lower than thatin the bupivacaine group 8, 10, and 24 h postoperatively.Conclusion: Ketamine group showed delayed request ofadditional opioid analgesia (P < 0.001) with significantly lessopioid consumption (P < 0.001) as compared to bupivacaine.Ketamine has comparable effect to bupivacaine with longerduration of action and minimal adverse effects