Evaluation of the analgesic effect of ketamine as an additive to intrathecal bupivacaine in patients undergoing cesarean section

Khezri, M.B. and Ghasemi, J. and Mohammadi, N. (2013) Evaluation of the analgesic effect of ketamine as an additive to intrathecal bupivacaine in patients undergoing cesarean section. Acta Anaesthesiologica Taiwanica, 51 (4). pp. 155-160.

[img] Text
1-s2.0-S1875459713001288-main.pdf

Download (431kB)
Official URL: https://www.scopus.com/inward/record.uri?eid=2-s2....

Abstract

Objective Nowadays, conventional analgesic agents, which are widely used for pain relief after cesarean section, provide suboptimal analgesia with occasional serious side effects. We designed a randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy of intrathecal ketamine added to bupivacaine after cesarean section. Methods Sixty patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the two groups to receive either bupivacaine 10 mg combined with 0.1 mg/kg ketamine, or bupivacaine 10 mg combined with 0.5 mL distilled water intrathecally. The time to the first analgesic request, analgesic requirement in the first 24 hours after surgery, onset times of sensory and motor blockades, the durations of sensory and motor blockades, and the incidences of adverse effects such as hypotension, ephedrine requirement, bradycardia, and hypoxemia, were recorded. Results Patients who received ketamine had a significantly prolonged duration of anesthesia compared with those who did not in the control group 95% confidence intervals (CI) 195-217; p = 0.001. The mean time to the first analgesic request was also significantly longer in ketamine group (95% CI 252.5-275; p < 0.001). The total analgesic consumption in the 24 hours following surgery significantly lessened in the ketamine group compared with that of the control group (95% CI 2-2.5; p < 0.001). The two groups did not differ significantly in intraoperative and postoperative side effects. Conclusion Intrathecal ketamine 0.1 mg/kg co-administered with spinal bupivacaine elongated the time to the first analgesic request and lessened the total analgesic consumption in the first 24 postoperative hours in comparison with bupivacaine alone in the control group following elective cesarean delivery. Copyright © 2013, Taiwan Society of Anesthesiologists. Published by Elsevier Taiwan LLC. All rights reserved.

Item Type: Article
Additional Information: cited By 12
Uncontrolled Keywords: analgesic agent; bupivacaine; ketamine; local anesthetic agent; n methyl dextro aspartic acid receptor, adult; antagonists and inhibitors; cesarean section; controlled study; double blind procedure; female; human; intraspinal drug administration; Pain, Postoperative; pregnancy; randomized controlled trial, Adult; Analgesics; Anesthetics, Local; Bupivacaine; Cesarean Section; Double-Blind Method; Female; Humans; Injections, Spinal; Ketamine; Pain, Postoperative; Pregnancy; Receptors, N-Methyl-D-Aspartate
Subjects: WQ Obstetrics
QV Pharmacology
Depositing User: somayeh pourmorteza
Date Deposited: 29 Sep 2019 06:46
Last Modified: 29 Sep 2019 06:46
URI: http://eprints.iums.ac.ir/id/eprint/9529

Actions (login required)

View Item View Item