Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section

Fazel, M.R. and Forghani, Z. and Fakharian, E. and Akbari, H. (2010) Preemptive analgesic effect of ketamine in patients undergoing elective cesarean section. Clinical Journal of Pain, 26 (3). pp. 223-226.

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Objectives: In this study, the preemptive effect of a small dose of ketamine on postoperative wound pain and morphine consumption in patients undergoing elective cesarean section was evaluated. Methods: In a randomized, double-blind clinical trial, 60 women with American Society of Anesthesiologists class I and II identification undergoing elective cesarean section were enrolled. In the case group, the patients received 0.5mg/kg ketamine, and in the control group, they received isotonic saline, 5 minutes before the induction of anesthesia. Anesthesia was induced with 4mg/kg thiopental followed by 1.5mg/kg succinylcholine. A further neuromuscular block was achieved by using 0.2mg/kg of atracurium. Anesthesia was maintained with nitrous oxide 50 and halothane in oxygen. The lungs were mechanically ventilated. After fetus delivery, fentanyl (2μg/kg) and morphine (0.15mg/kg) were given intravenously. In the postanesthesia care unit and in the ward, all patients received morphine. Pain was assessed by the Visual Analog Scales at 2, 6, 12, and 24 hours postoperatively; the amount of morphine used and side effects were recorded. Results: There was no significant difference between the patients considering their operative details, homodynamic variables, side effects, and Apgar scores of their babies at first and fifth minutes. Significantly, lower amounts of morphine were used in the case group (4.8mg±2.5mg vs. 8.1mg±4.2mg) during the first 2 hours after surgery (P=0.01), but the difference was not significant during 2 to 24 hours (3.2±2.2 vs. 3.1±2.3). There were no statistical differences between the groups in pain 2, 6, 12, and 24 hours postoperatively. Discussion: Intraoperative low-dose ketamine had no effect on morphine consumption during 2 to 24 hours after surgery. No significant differences were seen in the pain scores of the 2 groups during the study period. The preoperative administration of 0.5mg/kg ketamine in patients undergoing cesarean section did not elicit a preemptive analgesic effect. Copyright © 2010 by Lippincott Williams & Wilkins.

Item Type: Article
Additional Information: cited By 25
Uncontrolled Keywords: atracurium; atropine; diclofenac; fentanyl; halothane; ketamine; morphine; neostigmine; nitrous oxide; ondansetron; oxytocin; placebo; suxamethonium; thiopental, adult; analgesic activity; anesthesia induction; Apgar score; article; artificial ventilation; cesarean section; clinical trial; controlled clinical trial; controlled study; double blind procedure; female; human; major clinical study; neuromuscular blocking; postoperative nausea and vomiting; postoperative pain; priority journal; randomized controlled trial; recovery room; visual analog scale; ward, Adult; Analgesia, Obstetrical; Analgesics; Analgesics, Opioid; Anesthetics, Dissociative; Cesarean Section; Double-Blind Method; Female; Fentanyl; Humans; Infant; Injections, Intravenous; Intraoperative Care; Ketamine; Morphine; Pain Measurement; Pain, Postoperative; Pregnancy; Preoperative Care; Treatment Outcome
Subjects: Medicine
Divisions: Faculty of Medicine > Clinical Sciences > Department of Aneasthesiology
Depositing User: editor . 2
Date Deposited: 26 Feb 2017 08:14
Last Modified: 08 Mar 2017 21:29

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