The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia.
10.3344/kjp.2013.26.3.270
- Author:
Seung Yeup HAN
1
;
Hee Cheol JIN
;
Woo Dae YANG
;
Joon Ho LEE
;
Seong Hwan CHO
;
Won Seok CHAE
;
Jeong Seok LEE
;
Yong Ik KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. hcjin@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
caesarean delivery;
ketamine;
patient-controlled analgesia;
preemptive analgesia;
spinal anesthesia
- MeSH:
Analgesia;
Analgesia, Patient-Controlled;
Anesthesia, Spinal;
Cesarean Section;
Female;
Fentanyl;
Humans;
Ketamine;
N-Methylaspartate;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis;
Pregnancy
- From:The Korean Journal of Pain
2013;26(3):270-276
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section. METHODS: Spinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-microg fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively. RESULTS: Significantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively. CONCLUSIONS: Intraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section.
