Effect of Ketamine Supplementation in Axillary Plexus Blockade: A Comparative Study.
Cureus December 1, 2025 Demetra Solomos, Aggeliki Bairaktari, Theodoros Xanthos et al.
Adding ketamine to ropivacaine, either intravenously or regionally, speeds the onset of sensory and motor blockade and reduces rebound pain after axillary brachial plexus block for below-elbow surgery. In a randomized trial of 81 patients, both routes of ketamine administration led to faster block onset and lower pain scores on the numerical rating scale at 16, 20, and 24 hours after surgery compared with ropivacaine alone. Motor block scores and the need for postoperative opioid rescue did not differ among groups. The findings suggest that ketamine as an adjuvant improves early postoperative analgesia without increasing opioid use.