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Indian Journal of Anesthesia and Analgesia

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Pre-Emptive Analgesic Efficacy of Preincisional I.V. Low Dose Ketamine (0.15mg/kg) in Patients Posted for L.S.C.S. Under Spinal Anaesthesia

Ashwin Sonkamble, Associate Professor, Dept. of Anaesthesiology, Grant Govt. Medical College, Mumbai, Maharashtra 400008, India. , Rahul Dahivelkar1 , Ashwin Sonkamble2 , Poornima Sonkamble3

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Indian Journal of Anesthesia and Analgesia 5(2):p 253-258, February 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5218.17

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Abstract

Introduction: Inadequate pain relief after caesarean section delivery impairs mother’s ability to optimally care for her infant and to breastfeed in the immediate postoperative period. Pre-emptive analgesia is an antinociceptive treatment that prevents the establishment of altered processing of afferent input which amplifies postoperative pain. The lower dose of ketamine is not associated with neonatal depression and complication is minimal with high patient acceptance. Aim and Objectives: To assess the pre-emptive analgesic efficacy of pre-incisional i.v. low dose ketamine in patients posted for L.S.C.S under spinal anaesthesia. Material and Methods: The present clinical prospective study was carried out in Department of Anesthesiology, during Dec. 2011 to Oct. 2013. Sixty parturients of ASA Grade I and II were randomly divided into two groups of 30 each, every even number patient received IV ketamine (group K) and every odd patient received normal saline (group B). Results: Highest level of sensory block reached in group B was T2 in 7% of patients and 10% of patients in group K. All patients had excellent sensory analgesia. Mean time of total duration of sensory block was 234.27±24.23min in group B and 230±28.8min in group K. Mean time of effective analgesia was 126±17.6 min in group B and 161.6±24.2 min in group K. Hypotension was noted in 12 (40%) in group B and in 9 (30%) in group K. Shivering was observed in 3 patients in group B. Conclusion: The pre-incisional administration of low dose intravenous ketamine delayed the time to first analgesic request in parturients. The study could not substantially demonstrate the preemptive analgesic property of ketamine.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5218.17

Keywords

Ketamine; Caesarian; Spinal Anesthesia; Pre-Emptive Analgesia; Low Dose. 

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