36. EVALUCATION OF POSTOPERATIVE ANALGESIC EFFICACY OF CONTINUOUS INTRAVENOUS INFUSION OF KETOROLAC AND KETAMINE AFTER CESAREAN SECTION
Main Article Content
Abstract
Objective: To compare the analgesic efficacy of intravenous infusion of Ketorolac and Ketamine with epidural analgesia for postoperative pain relief after cesarean section. To evaluate some of the adverse effects of intravenous infusion of Ketorolac and Ketamine.
Object and methods: A prospective, randomized, controlled study was conducted on 60 women undergoing cesarean section at Phu Tho provincial Obstetrics and Pediatrics Hospital, divided into two groups (30 patients each). Group I received a continuous intravenous infusion of Ketorolac (2 mg/kg/24h) and Ketamine (1 mg/kg/24h) for 48 hours. Group II received continuous epidural analgesia with Bupivacaine 0.1% + Fentanyl 2 mcg/ml. Pain relief was assessed using the VAS score and satisfaction level; adverse effects were recorded within 48 hours postoperatively.
Results: The mean resting VAS scores in both groups were < 4 at all-time points. Resting VAS scores at all postoperative time points in both groups were lower than at H0, with statistically significant differences (p < 0.05). Group I had a very satisfied level of 100%, group II had very satisfied and satisfied rates of 86.67% and 13.33%, respectively. The rates of very satisfied and satisfied patients in the two groups were different and this difference was statistically significant with p < 0.05.
Conclusion: Continuous intravenous infusion of Ketorolac and Ketamine is an effective and safe method for postoperative pain relief after cesarean section and can be a reasonable alternative to epidural analgesia.
Article Details
Keywords
Cesarean section, Ketamine, Ketorolac, postoperative analgesia, epidural anesthesia.
References
[2] Walder B, Schafer M, Henzi I, Tramèr M.R. Efficacy and safety of patient-controlled opioid analgesia for acute postoperative pain. Acta Anaesthesiol Scand, 2001, 45 (7): 795-804. doi:10.1034/j.1399-6576.2001.045007795.x.
[3] Behdad S, Hajiesmaeili M.R, Abbasi H.R, Ayatollahi V, Khadiv Z, Sedaghat A. Analgesic Effects of Intravenous Ketamine during Spinal Anesthesia in Pregnant Women Undergone Caesarean Section; A Randomized Clinical Trial. Anesthesiol Pain Med, 2013, 3 (2): 230-233. doi:10.5812/aapm.7034.
[4] Han S.Y, Jin H.C, Yang W.D et al. The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia. Korean J Pain, 2013, 26 (3): 270-276. doi:10.3344/kjp.2013.26.3.270.
[5] Atif M, Khurshid T, Haque I.U, Yousaf M.J, Syed F.T. Effect of intraoperative low dose ketamine infusion on postoperative analgesia: A randomized controlled trial, 2019, 11 (3).