A comparetive study between analgesic effect of low-dose intravenous ketamine and intrathecal fentanyl with spinal anaesthesia for caesarean section

Abstract EN

For Comparing the analgesic effects of intrathecal fentanyl and low-dose intravenous ketamine as adjuvants to intrathecal bupivacaine for Caesarean section.

Forty-five elective caesarean section patients were randomized into three groups.

Spinal anesthesia was '^formed with 15 mg hyperbaric bupivacaine in all groups.

Ketamine (0.15 mghg'1) or an equal volume of normal saline was given intravenously immediately after initiating spinal 0aesthesia in ketamine and control group respectively.

In fentanyl group, 10 fig fentanyl was ? added to intrathecal bupivacaine.

Arterial pressures, heart rate values, adverse effects, the time of first request for postoperative analgesia, visual analogue pain scores, total analgesic consumptions at 24 and 48 h were recorded in all patients.

The time to first request for analgesia was significantly longer in the ketamine (197 min) and fentanyl (165 min) groups compared to the control group (144 min).

Postoperative pain scores were significantly lower in the ketamine group than in both other groups.

Although the analgesic requirements during first 24 h were significantly lower in the ketamine group, there was no significant differences • between the groups during the following 24 h.

Intravenous low-dose ketamine combined with intrathecal bupivacaine for Caesarean section provides longer postoperative analgesia and lower postoperative analgesic consumption than bupivacaine alone suggesting a pre-emptive effect