Effect of low dose ketamine versus dexamethasone on intraoperative nausea and vomiting during cesarean section under spinal anesthesia

Abstract

Objectives: The purpose of our study was to evaluate the prophylactic use of low dose ketamine and comparing it to dexamethasone for reducing intraoperative nausea and vomiting (IONV) during cesarean section under spinal anesthesia. Methods: The study was performed in 135 full term parturient women of ASA I & II (American Society of Anesthesiology Grade I & II), aged between 20 and 40 years with uncomplicated pregnancies. The group I (n = 45) received 0.4 mg/kg ketamine, group II (n = 45) received 8 mg dexamethasone while control group III (n = 45) received 5 ml normal saline, slowly IV immediately after spinal anesthesia and before surgical incision. The number of episodes of nausea and vomiting was recorded, as well as any other adverse effects. Results: The results of this study showed that the rate of nausea and vomiting was lower in patients who received 0.4 mg/kg ketamine and 8 mg dexamethasone than in the placebo group with significant reduction in hypotensive episodes in ketamine group (P = 0.02). Conclusion: Low dose ketamine is effective as dexamethasone in prevention of IONV during cesarean section under spinal anesthesia.

A Comparative Study on Effect of Low Dose Ketamine versus Dexamethasone on Intraoperative Nausea and Vomiting during Cesarean Section under Spinal Anesthesia

“…In the present study the incidence of hypotension was insignificant in different groups (P = 0/885) while in the study of Hassanein et al [19] there was no difference in Ephedrine administration (the average amount in those who suffered hypotension and received ephedrine), between Ketamine and dexamethasone groups, while the control group showed a significant high dose of total Ephedrine administration when compared to Ketamine and Dexamethasone groups (8 ± 3.2 versus 4.5 ± 2.1 in Ketamine group, and 5.3 ± 2 in Dexamethasone group), and a significant high rate of hypotensive episodes when compared to ketamine group (84.4% versus 64%).…”

“…In the study performed by Ahmed Hassanein and Eissa Mahmoud [19] in Egypt in 2014 on 135 patients candidate for cesarean section, Aiming to determine the effects of low dose Ketamine versus Dexamethasone on intraoperative nausea and vomiting during C/S; The incidence of nausea and vomiting in Dexamethasone group (28/8%) and Ketamine group (22/2 %) (51/1%) were significantly lower than the control group.…”

“…Numerous studies have shown the effect of Dexamethasone in reducing nausea and vomiting [2,4,11]. It is assumed that Ketamine induced rising of blood pressure can reduce the incidence of spinal induced hypotension and consequently reduce nausea and vomiting [7,17,19]. In this study, we aimed to compare the efficacy of low dose ketamine versus Dexamethasone on IONV during C/S under spinal anesthesia.…”

Effect of Intravenous Ketamine on Hypocranial Pressure Symptoms in Patients with Spinal Anesthetic Cesarean Sections: A Systematic Review and Meta-Analysis

“…After screening the titles and abstracts, only thirty studies were considered eligible for full reading. Twelve studies met all the selection criteria [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] as determined through browsing the titles, abstracts, and full texts ( Figure 1 ). The included articles were published between 2005 and 2020, with sample sizes ranging from 28 to 163.…”

Comparison of ondansetron and low dose Ketamine as agents for prevention of intraoperative nausea and vomiting during caesarean section under spinal anaesthesia

“…Ahmed hasnain and A M Shabana used low dose ketamine infusion in CS and found reduction in incidence of nausea. 25,26 The APGAR score at 1 min and 5 min in all the neonates was more than 9. Ketamine use during CS has been found safe interms of both maternal and fetal safety, with neonatal 1 min and 5 min APGAR scores being more than 9 when used as IV inducing agent in CS.…”