Dexmedetomidine-ketamine in Femur Proximal Fracture Patients

Comparison Study of Analgesic Effects for Dexmedetomidine-fentanyl vs Dexmedetomidine-ketamine in Femur Proximal Fracture Patients

• Comparison study of analgesic effects for dexmedetomidine-fentanyl vs dexmedetomidine-ketamine
• lateral position for spinal anesthesia in femur proximal fracture patients

• Dexmedetomidine (1mcg/kg)- fentanyl (1mcg/kg) vs dexmedetomidine (1mcg/kg) - ketamine (1mg/kg) 10 minutes loading.
• After 10 minutes of drug infusion, patients are prepared for spinal anesthesia.
• pain scale and quality of patient positioning are measured three times (lateral position, chest-knee position, intrathecal local anesthetics injection)
• When patients have severe pain during intraoperative period, fentanyl 50 mcg will be intravenously inject.
• Patients will be injected propofol 10mg when they have agitation signs during operation.
• vital signs, bispectral index, korean version of mini mental status examination, verbal rating scale,fentany/propofol consumption, frequency of intrathecal injection

Inclusion Criteria:

• American society of anesthesiologists classification 1-3 patients
• >20 years old

Exclusion Criteria:

• patients refuse
• dementia patients, cooperation difficult patients
• anaphylaxis of dexmedetomidine, ketamine, local anesthetics
• heart problem (bradycardia, atrioventricular block)