Key result
IV ketamine cuts hemodynamic instability during spinal anesthesia ~83% vs. fentanyl.
Why the study?
Hypotension is a frequent complication during spinal anaesthesia and is associated with increased postoperative mortality, necessitating evaluation of ketamine versus fentanyl for circulatory stability.
Does intravenous ketamine prevent severe hypotension during spinal anaesthesia in patients undergoing hip fracture surgery compared to fentanyl?
Population
30 ASA I-III patients undergoing spinal anaesthesia for hip fracture osteosynthesis
Comparison
Intravenous ketamine vs intravenous fentanyl during spinal anaesthesia
Design
Randomized controlled trial
Follow-up
40 minutes
Authors
Loading...
May support ketamine for hemodynamic stability in spinal anesthesia; hypothesis-generating Level 5 finding leaves open confirmation before practice change.
RCT (n=30)
Does intravenous ketamine prevent severe hypotension during spinal anaesthesia in patients undergoing hip fracture surgery compared to fentanyl?
Absolute Event Rate: 6.67% vs 40%
p-value: p=<0.05
Intravenous ketamine administration during spinal anaesthesia helps maintain haemodynamic stability and reduces the incidence of severe hypotension compared to fentanyl.
Hemmingsen et al. (1991) conducted an RCT in Spinal anaesthesia for osteosynthesis of hip fractures (n=30). Ketamine vs. Fentanyl (1.5 mg/kg BW i.v. before anaesthesia) was evaluated on Haemodynamically unstable condition (reduction in MAP >33% or systolic pressure <80 mmHg) (p=<0.05). Intravenous ketamine significantly reduced the incidence of haemodynamic instability during spinal anaesthesia compared to fentanyl (6.7% vs 40.0%; P<0.05).
Synapse has enriched one closely related paper. Consider it for comparative context: