الفهرس 
Introduction & Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
This study was conducted at EL-Minia University Hospital during the period from April 2012 to june 2013, the study involved 60 patients of either sex, aged 18-60 years old, ASA I & II and undergoing elective below knee surgery under combined sciatic-femoral nerve block guided by a nerve stimulator.
Patients were randomly divided into three equal groups; Group A (control group, n=20) received 40 ml of mixture of lidocaine 2% and bupivacaine 0.5%. Group B (ketamine group, n=20) received the same amount of local anesthetics with ketamine (50mg). Group C (dexamethasone group, n=20) received the same amount of local anesthetics with dexamethasone (8mg).
The aim of this study was to compare the effect of adding ketamine versus dexamethasone to local anesthetics mixture in combined sciatic-femoral nerve block on onset time of sensory & motor blocks and postoperative analgesia.
The variables included: heart rate, mean arterial blood pressure, oxygen saturation, onset time of sensory and motor blocks, visual analogue scale, duration of analgesia, resolution of motor block, total analgesic consumption, patient satisfaction score, and adverse effects were recorded.
The results of this study found that heart rate, mean arterial blood pressure and oxygen saturation, they were stable with minimal variation, which were not significant.
The mean onset time of sensory and motor blocks was significantly decreased in ketamine group(20.65 ± 4.62 min.) and dexamethasone group(21.65± 4.43 min) than in control group (27.3 ±5.44 min.).
The visual analogue scale was significantly lower in patients received ketamine and dexamethasone versus patients received local anesthetics only. The duration of analgesia and resolution of motor block were significantly prolonged in ketamine and dexamethasone groups as compared to control group. The postoperative analgesic consumption was reduced significantly in ketamine and dexamethasone groups in comparison with control group.