EFFICACY AND SAFETY OF LOW DOSE KETAMINE AS AN ADJUNCT ANALGESIC IN CAESAREAN SECTION UNDER GENERAL ANESTHESIA

DR. D. NIRANJAN; DR S. Magesh Selvaraj; DR.B.JEYA RANI

Volume : VII, Issue : XI, November - 2017

EFFICACY AND SAFETY OF LOW DOSE KETAMINE AS AN ADJUNCT ANALGESIC IN CAESAREAN SECTION UNDER GENERAL ANESTHESIA

Dr. D. Niranjan, Dr S. Magesh Selvaraj, Dr. B. Jeya Rani

Abstract :

Background and aims: The practice of avoiding sedatives or anxiolytics in caesarean section under general anesthesia (GA) until delivery of the baby could result in exaggerated hemodynamic responses and an increased risk of awareness. We aimed to assess the efficacy and safety of low dose ketamine, used as an adjunct analgesic and amnesic, in attenuating these responses during caesarean section under GA.

Methods: This prospective, randomized double blinded study was conducted in 60 patients. Group K (n = 30) received 0.25 mg/kg ketamine, whereas Group C (n=30) received 5 ml normal saline intravenously (IV) just before induction of anaesthesia. After intubation, patients were ventilated with O₂ and N₂O (33% : 66%) with 0.7% isoflurane. Fentanyl and midazolam were given following delivery of the baby. Chi square test and student T test were used for statistical analysis.

Results: Pre –induction hemodynamic parameters and those recorded at 1 min after induction were comparable in both groups. However, heart rate systolic blood pressure and mean arterial pressure (at 3, 5, 7, 9, 12, 15, 20, 30 and 45 minutes after induction) showed significantly high values in Group C (P < 0.05). Apgar score at 1 min, and at 5 min in both the groups had comparable scores. In Group C, intraoperative lacrimation (57 vs.1 0%) and recall of intraoperative events (17 vs. 3%) were high.

Conclusion: IV ketamine 0.25 mg/kg can be safely used as an adjunct analgesic and amnesic to attenuate hemodynamic responses during caesarean section under GA without affecting the foetal outcome.