Comparative Evaluation Of Combined Use Of Intravenous Dexmedetomidine-Ketamine With Dexmedetomidine Alone Along With Peripheral Nerve Blocks For Split Skin Grafting From Lower Limbs In Adults

Abstract

Split skin grafting is a minor surgical procedure involving transplantation of skin which can be carried out under topical, general, spinal anaesthesia or under controlled sedation. This study involves carrying out split skin grafting under controlled sedation using intravenous dexmedetomidine and ketamine along with peripheral nerve blocks and thereby providing a comparative evaluation of the combined use of dexmedetomidine and ketamine with dexmedetomidine alone.

50 patients planned for split skin grafting were randomly divided into two groups. Group DK received ketamine first at 0.8mg per kg over 1 minute followed by dexmedetomidine infusion at 0.3-0.5mcg per kg per hr. Group D received dexmedetomidine first at 1mcg per kg over 10 minutes followed by dexmedetomidine infusion at 0.3-0.5mcg per kg per hr. Pain was assessed based on movement, vocal response, tachycardia and hypertension.

The combined use of dexmedetomidine and ketamine along with peripheral nerve blocks was found to provide adequate sedation and analgesia in patients undergoing minor surgical procedures like split skin grafting.

Hemodynamic stability was maintained in the majority of the patients.