Comparison of conventional anaesthesia, total intravenous ketamine and epidural block for abdominal hysterectomy.

Techniques of total intravenous anaesthesia with ketamine and continuous epidural block are compared with the conventional method of using halothane, nitrous oxide and relaxant. Both ketamine and epidural techniques were associated with minimal cardiovascular disturbances, low blood loss and better quality of anaesthesia and recovery scores. The usual psychomimetic effect associated with ketamine administration was observed in only one patient. Further experience of total intravenous ketamine anaesthesia with adjunctive use of fentanyl to attenuate cardiovascular effects and midazolam for the pyschomimetic effect can further refine the technique. Cerebral function monitoring, if possible, will allow correlation of depth of anaesthesia with drug dosage and can ensure appropriate anaesthetic depth and recovery.