S Ketamine Use in Total Abdominal Hysterectomy

This study investigates the effect of low dose S+ketamine compared to placebo on cumulative morphine consumption at 24 hours in women undergoing open abdominal hysterectomy with remifentanil-propofol target controlled infusion. It compares the adverse effect profile in patients receiving S+ketamine as compared to those who did not. Participants are randomly distributed in two groups of 45 patient's each.

Inclusion Criteria: * Females above the age of 21 years old scheduled undergoing open abdominal hysterectomy with remifentanil-propofol TCI in KKH for benign condition (fibroids, adenomyosis), * Be willing and able to give written informed consent for participation in this study * ASA I/II patient's. Exclusion Criteria: * Patient with contraindications to the use of S+ketamine, as listed in the product label e.g. untreated or insufficiently treated thyroid hyperfunction, unstable angina pectoris or myocardial infarction within the last 6 months, diseases of the CNS, increased intraocular pressure and perforating ocular injuries, surgical procedures in the upper respiratory tract, etc * Patients with a h/o drug or alcohol abuse * Regular use of analgesics, or use of opioids within 12 hours of surgery * Patient on chronic use of benzodiazepine or neurololeptics * Patient on thyroid replacement hormone * H/o IHD,HTN,Thyroid disorder. * BMI\> 30kg/m2. * H/o Psychiatric disorder. * Laproscopic surgery converted to open surgery. * Pregnant or breast feeding female's.