الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
This study was conducted at EL-Minia University Hospital during the period from April 2011 to December 2011, the study involved 40 patients of either sex, aged 18-60 years old, ASA I & II and undergoing elective forearm surgery under infraclavicular brachial plexus block guided by a nerve stimulator.
Patients were randomly divided into two equal groups; Group A (control group, n=20) received 40 ml of mixture of lidocaine 2% and bupivacaine 0.5%. Group B (ketamine group, n=20) received the same amount of local anesthetics with ketamine (50mg).
The aim of this study was to evaluate the effect of adding ketamine to local anesthetics mixture in infraclavicular brachial plexus block on onset time of sensory & motor blocks and postoperative analgesia.
The variables included: heart rate, mean arterial blood pressure, oxygen saturation, onset time of sensory and motor blocks, visual analogue pain scale, duration of analgesia, resolution of motor block, total analgesic consumption, sedation score, patient satisfaction score, and adverse effects were recorded.
The results of this study found that heart rate, mean arterial blood pressure and oxygen saturation, they were stable with minimal variation, which were not significant.
The mean onset time of sensory and motor blocks was significantly decreased in ketamine group than in control group.
The visual analogue pain scale was significantly lower in patients received ketamine versus patients received local anesthetics only. The duration of analgesia and resolution of motor block were significantly prolonged in ketamine group as compared to control group. The postoperative analgesic consumption was reduced significantly in ketamine group in comparison with control group.
Light and short lived increased degree of sedation was observed in ketamine group with no sedation in control group. Percentage of patients who satisfied from the technique was significantly higher in ketamine group patients than control group patients.
The incidence of complications in ketamine group was low where hallucinations and bad dreams occurred in this group. While there was no side effects occurred in control group. And no complications occurred related to the technique.
We concluded that the addition of ketamine in a dose of (50 mg) to local anesthetics in infraclavicular brachial plexus block results in a significant decrease in onset time of sensory & motor blocks, prolonged duration of postoperative analgesia, lower analgesic consumption with a high degree of patient satisfaction as compared to local anesthetics alone in patients undergoing elective forearm orthopedic surgeries.