Citation Information :
Sethi SK, Jain N, Jain K, Thada B. Efficacy of Low-dose Intravenous Ketamine vs Intravenous Tramadol Infusion for Postcesarean Section Analgesia following Spinal Anesthesia: A Prospective, Randomized, Double-blinded Clinical Study. Res Inno in Anesth 2018; 3 (1):1-7.
Background: Postoperative pain is of greatest concern in parturients undergoing cesarean section. Low-dose intravenous (IV) ketamine infusion has been considered to be an effective postoperative analgesia and resurged again as a substitute of opioid analgesics. This study aims to evaluate the efficacy of low dose iv ketamine versus iv tramadol infusion in reducing postoperative pain and rescue analgesic requirements.
Materials and methods: This prospective study was conducted on 150 parturients with American Society of Anesthesiologists (ASA) grades I and II, aged 18 to 35 years scheduled to undergo elective or emergency cesarean section under regional anesthesia. All the parturients were randomly allocated into three groups of 50 patients each. Group C (control group) received 5 mL saline; group K (ketamine group) received 5 mL of ketamine (0.05 mg/kg/hour); and group T (tramadol group) received 5 mL of tramadol (120 mg/24 hours) in 500 mL of Ringer's lactate. Tramadol (1 mg/kg) was given as rescue analgesic. Pain scores, patient satisfaction scores, time to first demand of rescue analgesic, the total number of doses, and total consumption of rescue analgesic along with side effects were recorded.
Results: The cumulative visual analog scale (VAS) noted at rest, cough, and movement was significantly less in groups K and T as compared with group C (p < 0.001). The time of requirement of first rescue analgesic dose was significantly prolonged in group K (6.17 ± 3.05 hours) and group T (4.04 ± 1.26 hours) as compared with group C (2.16 ± 0.84 hours) (p < 0.001). The total number of doses of rescue analgesic given in 24 and 48 hours was significantly decreased in groups K and T as compared with group C (p < 0.001). The satisfaction scores were significantly better in groups K and T (p < 0.001).
Conclusion: We concluded that low-dose IV ketamine infusion was associated with significantly lower pain scores, reduced rescue analgesic requirement along with better patient satisfaction so that it could be used as a useful adjunct to multimodal postoperative analgesia.
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