Effect of Low-Dose Intravenous Ketamine on Postoperative Pain after Cesarean Section following under Spinal Anesthesia in Zewditu Memorial Hospitals, Addis Ababa, Ethiopia, 2021, a prospective observational cohort study
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Date
2021-06
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Addis Abeba University
Abstract
Background: Cesarean section is common obstetric procedures worldwide. Following cesarean
delivery, mothers experience moderate to severe pain since postoperative analgesia of spinal
anesthesia is limited by duration of local anesthesia drug used. Analgesic effect of local
anesthesia agents could be extended by adding adjuvants like neostigmine, opioid and low dose
of intravenous ketamine.
Objective: This study was assess effect of low-dose intravenous ketamine on postoperative pain
following cesarean section with spinal anesthesia in Zewditu Memorial Hospital, Ethiopia, 2021
Method: Sixty pregnant mothers planned for elective cesarean delivery under spinal anesthesia
were involved in this prospective cohort study at zewditu memorial hospital. Participants were
selected by systematic random sampling technique. Numerical rating scale pain score, time to
request first analgesia and total analgesia consumptions were recorded in first 24 hours.
Independent sample t- test, Mann–Whitney U-test and a chi-square was used for analysis based
on distribution of data.
Result- Numerical rating scale pain score at 1
st
and 2
nd
hour after surgery was significantly
different between the groups with p≤ 0.05. But pain score at 6
th
, 12
th
, 18
th
and 24
insignificant.
Time to request first analgesia was significantly longer in exposed than Non-exposed group with
p< .0001.The median(range) of tramadol consumption in 24 hour was 100(100_100) for exposed
and 150(100_150) for non-exposed which was significant difference between both groups with
(p- value ˂ .0001). But, diclofenac consumption was not significantly different (p =.576).
Conclusion and Recommendation: Low dose intravenous ketamine (0.25mg/kg) before skin
incision was extended postoperative first analgesia request by average of 45.5minutes and
decrease total analgesia consumption in 24 hours. Based on this we recommend use of low dose
ketamine as a part of postoperative pain treatment.
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Keywords
Cesarean section, postoperative pain, Intravenous ketamine