Comparison between ketamine and propofol combined against propofol alone for brachial plexus nerve block in open fixation of forearm fracture: A randomized controlled trial

Abstract

Background: General anesthesia has been successfully replaced by various nervous block for surgeries. Objective: The purpose of this study was to examine the combined effect of ketamine and propofol for brachial plexus block. Method: In this double-blind randomized trial, 64 patients who underwent open fixation for forearm fracture were randomly assigned to group A (n = 32); comprising of patients who received both propofol (200 mg) and ketamine (50 mg) or group B (n = 32) who received only propofol (200 mg). The infusion was controlled in the groups to induce light-to-moderate sedation. The visual analogue scale (VAS) was used to evaluate pain in the groups. Additionally, parameters such as nausea and vomiting, patients’ satisfaction, blood pressure, heart rate, hallucination and the time of recovery were compared among the groups. Result: Due to the failure of nerve block, 7 patients were excluded from the study. A total of 64 patients were equally divided into two groups. Pain, nausea, vomiting, hallucination and patients’ satisfaction were not statistically different among the two groups. Whereas, changes in the blood pressure and heart rate were lesser in Ketamine-propofol group and however, were not reported to be statistically significant. Conclusion: Admixture of ketofol, containing a small dose of ketamine, is not an appropriate analgesic adjunct for upper arm nerve block, however, it does not increase the incidence of nausea, vomiting and hallucination. Highlights:

Evaluating memory dysfunction after spinal anesthesia among patients undergoing elective surgery: Descriptive-analytical study

“…A recent study has indicated that decrease in glial cell-derived neurotrophic factor leads to neuroinflammation in animal model and can cause memory dysfunction [ 8 ]. Alterations in gene expression after general anesthesia is also reported to lead to neuroplasticity [ 9 , 10 ]. Owing to known effects of general anesthesia in cognitive impairment, a number of studies have argued on substituting general anesthesia with regional anesthesia [ 4 , 11 , 12 ].…”