A COMPARATIVE STUDY OF CAUDAL BLOCK USINGLIGNOCAINE ALONE AND WITH KETAMINE FOR ADULTANORECTAL SURGERIES

Background -we want to compare the effects of lignocaine alone & lignocaine with ketamine in the caudal block for anorectal surgeries Methods- A prospective, randomized, comparative study was conducted at the Department of Anaesthesiology, ACSR Govt Medical college on 50 ASA I, and II patients aged between 18 to 60years posted for elective anorectal surgeries, during the period of November 2020 to February 2022,by dividing the patients into two groups Results-In this study the mean time to the first analgesia was 7.9 min. in the control group and 5.6 in the study group (p < 0.05). The mean time to start was 13 min. in the control and 11 min. in the study group (p < 0.05). The sensory block level reached in the control group was T12 and in the study group was T 10. The motor blockade was significantly less in the study group than in the control group (p < 0.05). Anal sphincter relaxation was better in the study group than in the control group. The discomfort caused by the awkward positioning was less in the ketamine group than in the control. In the study group, patients had acceptable sedation which contributed to a sense of well-being superior patient satisfaction and better working conditions for surgery. Both groups were compared in the incidence of intraoperative and postoperative complications. In the study group the total duration of analgesia was significantly prolonged (210 min. vs. 247 min. p value <0.05 ) There was no hypotension in the study group whereas in the control group there was a mean fall of 4 mm Hg. in the systolic BP. The addition of Ketamine in the subanaesthetic dose of 0.5 mg / Kg to the Caudal epidural block provides comparatively better anaesthesia than Lignocaine alone. Conclusion- We concluded that Caudal Epidural Block ( CEB) using Lignocaine 30 ml with Adrenaline ( 1 in 200 000 dilutions) is a safe, reliable and simple technique that can be practised for this kind of surgery. Ketamine as an adjuvant in sub anaesthetic doses significantly improves the quality,duration, and patient comfort in the caudal block.