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The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia

BACKGROUND: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases pos...

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Autores principales: Han, Seung Yeup, Jin, Hee Cheol, Yang, Woo Dae, Lee, Joon Ho, Cho, Seong Hwan, Chae, Won Seok, Lee, Jeong Seok, Kim, Yong Ik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Pain Society 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710941/
https://www.ncbi.nlm.nih.gov/pubmed/23862001
http://dx.doi.org/10.3344/kjp.2013.26.3.270
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author Han, Seung Yeup
Jin, Hee Cheol
Yang, Woo Dae
Lee, Joon Ho
Cho, Seong Hwan
Chae, Won Seok
Lee, Jeong Seok
Kim, Yong Ik
author_facet Han, Seung Yeup
Jin, Hee Cheol
Yang, Woo Dae
Lee, Joon Ho
Cho, Seong Hwan
Chae, Won Seok
Lee, Jeong Seok
Kim, Yong Ik
author_sort Han, Seung Yeup
collection PubMed
description BACKGROUND: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section. METHODS: Spinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-µg fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively. RESULTS: Significantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively. CONCLUSIONS: Intraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section.
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spelling pubmed-37109412013-07-16 The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia Han, Seung Yeup Jin, Hee Cheol Yang, Woo Dae Lee, Joon Ho Cho, Seong Hwan Chae, Won Seok Lee, Jeong Seok Kim, Yong Ik Korean J Pain Original Article BACKGROUND: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section. METHODS: Spinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-µg fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively. RESULTS: Significantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively. CONCLUSIONS: Intraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section. The Korean Pain Society 2013-07 2013-07-01 /pmc/articles/PMC3710941/ /pubmed/23862001 http://dx.doi.org/10.3344/kjp.2013.26.3.270 Text en Copyright © The Korean Pain Society, 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Han, Seung Yeup
Jin, Hee Cheol
Yang, Woo Dae
Lee, Joon Ho
Cho, Seong Hwan
Chae, Won Seok
Lee, Jeong Seok
Kim, Yong Ik
The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia
title The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia
title_full The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia
title_fullStr The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia
title_full_unstemmed The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia
title_short The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia
title_sort effect of low-dose ketamine on post-caesarean delivery analgesia after spinal anesthesia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710941/
https://www.ncbi.nlm.nih.gov/pubmed/23862001
http://dx.doi.org/10.3344/kjp.2013.26.3.270
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