Volume : VIII, Issue : XII, December - 2018

INTRAVENOUS LOW DOSE KETAMINE INFUSION FOR LABOUR ANALGESIA - A Prospective Interventional Clinical Trial

Dr. M. Ravikumar, Dr. K. Chandran

Abstract :

 BACKGROUND:  Ketamine is a short acting anesthetic with excellent analgesic property,and has been widely used for short surgical procedures like wound suturing and dressing. It has been shown that in low doses, intravenous ketamine provides good intraoperative and postoperative analgesia. This prospective interventional study was an effort to evaluate the efficacy of low dose ketamine as a labour analgesic, thereby providing a safe and inexpensive alternative, especially for the developing countries with limited resources and economical constraints.

AIM: The aims of this study are:

1. To evaluate the efficacy of low dose intravenous ketamine in providing

analgesia during labour.

2. To assess the safety of low dose intravenous ketamine on the parturient and

the fetus, and its effect on the progress of labour.

3. To standardise a “low dose ketamine” regimen for labour analgesia.

METHODS:

Parturients with no antenatal risk factors and expected to have normal

vaginal delivery were eligible to be included in the study. Women with known

cardiac disease, gestational hypertension, epilepsy or known psychiatric disorder were excluded, as were parturients with multifetal pregnancy, suspected cephalopelvic disproportion and those who have had previous caesarean section.

RESULTS: All the parturients experienced adequate analgesia within 1–2hrs of administration of ketamine infusion. The infusionrate of ketamine during the course of labour was also calculated and the average infusion required was 0.17 +/– 0.06mg.kg–1.hr–1 (range 0.08–0.32). The parturients who had a spontaneous onset of labour required a lower dose of ketamine when compared to those who had induction of labour.The changes in heart rate and blood pressure were statistically  insignificant.

 CONCLUSION: Ketamine, a NMDA receptor antagonist, is shown to be an excellent analgesic. Although it is associated with unpleasant side effects, these can be minimised when ketamine is administered slowly in very low doses

(0.1–0.2mg.kg–1.hr–1) while retaining its analgesic property. Since, the efficacy and safety of low dose intravenous ketamine as a labour analgesic has been established, a regimen, with slight modification, would be ratified on a larger population, before being recommended as a standard technique of labour analgesia.

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

INTRAVENOUS LOW DOSE KETAMINE INFUSION FOR LABOUR ANALGESIA – A Prospective Interventional Clinical Trial , Dr.M.RaviKumar, Dr.K.Chandran , INDIAN JOURNAL OF APPLIED RESEARCH : Volume-8 | Issue-12 | December-2018

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