Objectives
Evaluation of anesthetic and surgical outcome on using a combination of ketamine and lidocaine for induction of anesthesia and as intraoperative
analgesia in comparison to fentanyl.
Patients and Methods
120 males assigned to undergo unilateral inguinal hernia repair requiring operative time less than 60 minutes were randomly divided into two groups:
Group F received induction using fentanyl 1-2 ug/kg and intraoperative analgesia as a loading dose of fentanyl (1 μg/kg) over 1 minute followed by a continuous infusion of 0.3 μg/kg/h. Group L received induction by boluses of ketamine (0.5 mg/kg) and lidocaine (1 mg/kg) and intraoperative analgesia
using a bolus dose of ketamine (0.5 mg/kg) and lidocaine infusion at a rate of 2 mg/kg/h.
Results
During the operative time, 28 and 79 patients had decreased mean arterial pressure by >20% and <20% of preoperative mean arterial pressure value,
respectively with non-significant difference between both groups. Thirteen patients had an episode of increased mean arterial pressure up to <10% of
preoperative mean arterial pressure with a significantly higher incidence in group L. At 30-min mean arterial pressure, both heart rate and mean arterial pressure measurements were significantly higher in patients of group L. Patients of group L had significantly faster post-anesthetic care unit discharge, but shorter time till the first request of rescue analgesia.
Conclusion
The applied intraoperative analgesia using ketamine and lidocaine infusion is a possible alternative for intraoperative fentanyl for short-duration surgical
procedures. Usage of intraoperative ketamine/lidocaine infusion improved recovery parameters and reduced post-procedural complications with a shortduration postoperative hospital stay.
Author(s): Rami Mounir Wahba, George Mikhael Nakhla, Ayman Anis Metry*, and Milad Zekry Ragaei