Health Condition 1: O- Medical and Surgical
Conditions
Interventions
Intervention1: Ketamine addition: 2mg/kg ketamine will be added to 12 ml 0.5 % bupivacaine. The total amount of drug taken will be 18 ml and it will be prepared by adding the normal saline for the rem
Sponsors
AIIMS Rishikesh
Eligibility
Inclusion criteria
Inclusion criteria: ASA I-III patients in the age group mentioned above with Glasgow coma scale 13-15 who are scheduled for elective supratentorial craniotomies will be included in our study.
Exclusion criteria
Exclusion criteria: Below mentioned are our exclusion criteria: 1. Refusal of consent. 2. Local infection at the injection site 3. Patients with coagulation disorders/thrombocytopenia 4. Patients with Glasgow Coma Scale (GCS) 5. Patients having psychotic disorders/ substance abuse. 6. Patients with poor cognitive functions preoperatively. 7. Patients with chronic headache or on analgesics for long duration. 8. Known or suspected allergy to study drugs. 9. Patients with uncontrolled hypertension, uncontrolled diabetes mellitus or heart disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Heart rate and mean arterial blood pressure following pin application in supratentorial craniotomies.Timepoint: At 1 minute and 5 minutes following head pin application. | — |
Secondary
| Measure | Time frame |
|---|---|
| Blood sugar levels till 24 hours postoperativelyTimepoint: Baseline after shifting patient to operating table, immediately following induction, 10 min after head pin insertion, end of surgery, at extubation, 2 hours post operatively and 24 hours post operatively;Brain relaxation score following opening of dura mater.Timepoint: At dura mater opening;Critical-Care Pain Observation Tool (CPOT) scoreTimepoint: 1 hour postoperatively, 4 hours postoperatively, 8 hours postoperatively, 16 hours postoperatively and 24 hours postoperatively.;Demand of first analgesic drug intraoperatively( more than 20% increase in heart rate and meaan blood pressure )Timepoint: Time when heart rate and mean blood pressure increase by more than 20% for the first time intraoperatively;Dose of rescue drug like propofol, fentanyl or beta blockers to treat hemodynamic fluctuations(heart rate and mean blood pressure change more than 20% of the baseline)Timepoint: At any time point;Perfusion index values intraoperatively and postoperativelyTimepoint: Baseline after shifting patient to operating table, 1 minute after induction of anesthesia, 5 minutes after induction of anesthesia, during scalp block, 1 minute after scalp block, 5 minutes after scalp block,during head pin application, 1 minute after head pin application, 5 minutes after head pin application,during incision, 1 minute after incision, 5 minutes after incision, every 30 minutes after incision until skin closure, during skin closure;Time of demand for first analgesic drug postoperatively-extubated patients complain of pain and presence of CPOT2 in both extubated and ventilated patientsTimepoint: Time when patient needs analgesia for the first time in post operative period;Total analgesic consumption (opioid/ NSAIDS) intraoperatively and postoperatively up to 24 hours.Timepoint: From entering in operating room upto 24 hours | — |
Countries
India
Contacts
Public ContactDr Sakshi Kadian
AIIMS Rishikesh
Outcome results
None listed