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
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 2
Abstract
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.
Authors and Affiliations
Rahul Dahivelkar
Efficacy of Spinal Anaesthesia as a Safer Technique in Laparoscopic Cholecystectomy with Better Outcome
Spinal anaesthesia is always a safe, cost effective and a better option in patients where general anaesthesia can be complicated and to fulfill the purpose of postoperative analgesia. After conducting many upper abdomin...
Comparison of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in Epidural Anaesthesia for infraumbilical Surgeries: An Observational Study
Aims: To assess the efficacy and compare the duration of analgesia, level of sedation and side effects of 0.75% ropivacaine with 50 mcg dexmedetomidine to 0.75% ropivacaine with 50 mcg fentanyl given epidurally. Study s...
Prediction of Difficult Intubation in Apparently Normal Patients by Combining Modified Mallampatti Test and Thyromental Distance
Context: Difficult intubation is associated with serious complications, more so when there is failure of intubation. Inability to secure the airway during general anaesthesia remains one of the leading causes of morbidit...
Comparative Study of Intrathecal Bupivacaine with 50 and 75 µg Clonidine in Lower Abdominal Surgeries
Background: Spinal anaesthesia is a safe, reliable, inexpensive technique of providing anaesthesia and blunts autonomic, somatic and endocrine responses. It has many advantages; the limited duration of action appears to...
Effect of Auto-Co-Induction of Propofol on Total Induction Dose and Haemodynamics
Rapid induction with propofol causes fall in arterial pressure and tachycardia.Our study aims at comparing the hemodynamic changes between rapid dose and priming dose, measure propofol requirement and evaluate complicati...