Study of Intravenous Ketamine Added to Spinal Anesthesia Compared to Spinal Anesthesia Alone in Older Adults Undergoing Lower Limb Surgeries

What this Trial Is About

Researchers are evaluating the effect of intravenous ketamine combined with spinal anesthesia on the duration of sensory block compared to spinal anesthesia alone in older adults undergoing lower limb surgeries. This study focuses on geriatric patients aged 65 years and above and aims to improve pain relief during and after surgery while minimizing side effects. The trial addresses the need for better adjuvants to spinal anesthesia in elderly patients to enhance block quality and prolong postoperative analgesia. Participants will receive either intravenous ketamine or saline alongside spinal anesthesia using hyperbaric bupivacaine 0.5%. The ketamine group receives a 0.2 mgkg dose diluted to 5 ml followed by a continuous infusion of 0.1 mgkghr as a 20 ml solution. The control group receives saline in similar volumes and infusion rates. This randomized, double-blinded trial compares these two approaches during elective lower limb surgeries with patients in the supine position. During the study, researchers will monitor the duration of two-segment sensory regression after spinal block delivery as the primary outcome. Secondary outcomes include total sensory block duration, motor block duration, and the time until the first request for rescue analgesia within 24 hours post spinal block. Participants will be assessed for motor and sensory function using standard methods, and safety will be observed throughout the perioperative period. The trial is led by Cairo University and is planned to conclude in August 2026.

Effect of Intravenous Ketamine Combined With Spinal Anesthesia on Sensory Block Duration Compared to Spinal Anesthesia Alone in Lower Limb Surgeries in Geriatrics.