The persisting analgesic effect of low-dose intravenous ketamine after spinal anaesthesia for Caesarean section

Şen, Selda; Özmert, Galip; Aydın, Osman Nuri; Baran, Namık K.; Çalışkan, Ercan

doi:10.1017/s026502150500089x

Cited by 45 publications

(57 citation statements)

References 20 publications

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“…ketamine (0.15 mg/kg) during spinal anesthesia for cesarean delivery had reduced 24-h intramuscular diclofenac requirements. 8 In patients undergoing laparoscopic gynecologic surgery, Kwok et al showed a small (1 mg) reduction of morphine in the PACU and minimal (1 tablet) paracetamol 325 mg/dextropropoxyphene 100 mg cumulative dose difference in the first week postoperatively in patients who received ketamine (0.15 mg/kg). 12 Dahl et al demonstrated no opioid-sparing effects with a single dose of ketamine (0.4 mg/kg) in subjects undergoing abdominal hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

“…ketamine (0.15 mg/kg) were administered during general or spinal anesthesia for cesarean delivery. 7,8 To our knowledge, the opioid-sparing effects of subanesthetic doses of ketamine in the setting of cesarean delivery under spinal anesthesia in patients receiving a multimodal analgesic regimen, including intrathecal morphine, has not been studied.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial

Bauchat

Higgins

Wojciechowski

et al. 2011

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial

Bauchat

Higgins

Wojciechowski

et al. 2011

International Journal of Obstetric Anesthesia

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“…A Cochrane database review evaluating the postop analgesic effectiveness of ketamine, reported that perioperative ketamine reduces postop opioid requirements and reduces PONV (6). There are also studies that do not report significant differences in the ketamine and the control groups in terms of side-effects (10,15,27). Shabana et al explained their diminished incidence of PONV in their study with reduced incidence of hypotensive episodes that ketamine provides by its sympathomimetic and vagolytic effects (28).…”

Section: Resultsmentioning

confidence: 99%

“…For this purpose, studies on the control of post-operative acute pain continue to provide a solution with different analgesic drugs with fewer side effects (7)(8)(9). Ketamine is one of the important drugs that are effectively used in multimodal analgesia during caesarean section operations and that is subject of the studies (7,10,11). Ketamine usually shows its pharmacologic effects via NMDA (N-Methyl-DAspartate) antagonism (12,13).…”

Section: Introductionmentioning

confidence: 99%

Peri̇operati̇f Düşük-Doz Ketami̇n Spi̇nal Anestezi̇ Uygulanan Gebelerde Postoperati̇f Sezeryan Ağrisini, Bulanti Ve Kusma Sikliğini Azaltir Mi?

Edipoğlu¹,

Çelik²,

Omaygenç³

2017

İstanbul Tıp Fakültesi Dergisi

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We also recorded the first additional analgesic demands and ketamine associated adverse events. Results: We detected significant differences between the visual analogue scale values of ketamine and control group in the 2 nd , 4 th and 12 th hours. Significant differences were also seen in the first analgesic demand periods. We found a significant decrease in nausea and vomiting and insignificant elevation of psychodysleptic findings in ketamine group. Conclusion: We believe that low-dose ketamine can be effectively used to sustain analgesia in pregnant patients who received spinal anaesthesia. We further believe that the effect of ketamine in decreasing nausea and vomiting, in exchange of low levels of neuropsychiatric symptoms, is a remarkable subject.

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“…Plusieurs études ont évalué à ce jour la place de ces adjuvants pour l'antalgie post-césarienne, et les résultats semblent plutôt favorables dans son usage postopératoire immédiat [40][41][42]. La seule étude à ce jour évaluant l'indication et surtout les bénéfices à long terme de la clonidine par voie intrathécale a démontré une réduction de l'incidence d'hyperalgésie mécanique suggé-rant une capacité à prévenir la douleur résiduelle après césarienne [24].…”

Section: Adjuvants (Analgé Sie Multimodale)unclassified

Analgésie obstétricale et douleurs du post-partum

Landau

2007

Douleur analg.

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Les douleurs sévères aiguës du post-partum sont plus fréquentes qu'on ne le croit que ce soit après un accouchement par voie vaginale ou une césarienne. De plus, l'incidence rapportée dans la littérature de douleurs chroniques post-césarienne est relativement élevée et avec l'augmentation constante du taux de césariennes, risque de devenir un problème tangible. Quand on interroge les femmes sur leurs craintes et angoisses les plus importantes pendant l'accouchement, celles-ci rapportent que la douleur pendant la césarienne est ce qui les effraie le plus. La variabilité interindividuelle dans la sévérité de la douleur post-accouchement ou césarienne est influencée par de multiples facteurs tels que la sensibilité à la douleur, des facteurs psychologiques, l'âge et la variabilité géné-tique entre autres. Cette revue tente de revoir le concept de modèles permettant de prédire le risque de douleur aiguë sévère et douleur neuropathique résiduelle après accouchement vaginal ou césarienne, ainsi que de présenter les modalités antalgiques efficaces dans le contexte de la césarienne, avec une mention particulière pour les stratégies visant à prévenir la chronicisation de la douleur du post-partum.Abstract: Acute severe post-partum pain occurs more often than is thought both after vaginal and cesarean deliveries. Furthermore, the incidence of chronic pain after cesarean section has been reported to be relatively high and with the constant increase in cesarean section rates this could become a significant clinical problem. When questioning women's fear and expectations, pain during and after cesarean section is the greatest concern. Individual variability in severity of post vaginal or operative delivery pain is influenced by multiple factors including sensitivity to pain, psychological factors, age, and genetics and leads to variability in postdelivery pain experience as well as requirements for analgesics. This review attempts to report on predictive models for the incidence of severe acute pain and chronic residual pain after both vaginal and cesarean deliveries, as well as present effective analgesic regimens for acute pain after cesarean deliveries with some focus on strategies to prevent chronicization of pain.

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The persisting analgesic effect of low-dose intravenous ketamine after spinal anaesthesia for Caesarean section

Abstract: Intravenous low-dose ketamine combined with intrathecal bupivacaine for Caesarean section provides longer postoperative analgesia and lower postoperative analgesic consumption than bupivacaine alone suggesting a pre-emptive effect.

Cited by 45 publications

References 20 publications

Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial

Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial

Peri̇operati̇f Düşük-Doz Ketami̇n Spi̇nal Anestezi̇ Uygulanan Gebelerde Postoperati̇f Sezeryan Ağrisini, Bulanti Ve Kusma Sikliğini Azaltir Mi?

Analgésie obstétricale et douleurs du post-partum

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