Evaluation of the Efficacy of Intravenous Ketamine on Prevention of Hypotension During Spinal Anaesthesia in Patients with benign Prostatic Hyperplasia

ABSTRACT

introduction: Hypotension is a common complicationduring spinal anaesthesia. The elderly patients due toreduced physiological reserves are more prone to developadverse effect of hypotension. Hypotension followingspinal anaesthesia is caused by paralysis of pre-ganglionicsympathetic fibers resulting in decrease systemic vascularresistance, decrease pre-load, decrease after-load, decreasestroke volume, decrease cardiac output resulting in decreaseblood pressure. Current study aimed to evaluate the effectsof intravenous ketamine on prevention of hypotension duringspinal anaesthesia.Material and Methods: Ninety (90) patients aged 50 to70 yrs. (ASA I-II) undergoing surgery for Benign ProstaticHyperplasia were randomly allocated to two groups – GroupK receiving i/v ketamine and Group B without i/v ketamine.After securing i/v line, infusion started with R/L. Followingspinal anaesthesia, ketamine was administered in the dose of.5 mg/kg b.w. to patients belonging to Group K.Results: In both groups, spinal anaesthesia resulted inreduction in Mean Arterial Pressure (MAP). MAP was lowerin the group without ketamine than in the ketamine group atall times. There was a significant change in heart rate in thecontrol group compared to ketamine group (p<0.05).Conclusion: We concluded that ketamine .5 mg/kg b.w.given intravenously just after spinal anaesthesia resulted ingreater hemodynamic stability in elderly patients undergoingtransurethral resection of prostate compared with controlgroup.