Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section

Background: Cesarean delivery is a frequently obstetric operation in Egypt with a recently reported over all cesarean section rate of 54% and it causes moderate to severe postoperative discomfort. Infiltration of the wound site is a method to improve postoperative analgesia. The aim of the work: To...

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Autores principales:	Nourhan R. Biomy, Asmaa Fathelbab, Amina Abdel-Fattah, Abeer E. Farhat
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:	ketamine dexmedetomidine local anesthesia wound infiltration Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/76672bf9b08c4505a4afadceea78f1ef
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spelling	oai:doaj.org-article:76672bf9b08c4505a4afadceea78f1ef2021-12-02T19:02:51ZKetamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section2636-41742682-378010.21608/ijma.2021.185126https://doaj.org/article/76672bf9b08c4505a4afadceea78f1ef2021-07-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_185126_6d8afd010cb4f4dc95f7b13a3b8cc124.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Cesarean delivery is a frequently obstetric operation in Egypt with a recently reported over all cesarean section rate of 54% and it causes moderate to severe postoperative discomfort. Infiltration of the wound site is a method to improve postoperative analgesia. The aim of the work: To compare the pain relief effects of ketamine versus dexmedetomidine combined to bupivacaine in local wound infiltration in patients underwent cesarean section and to estimate side effects of medications. Patients and Methods: This randomized, controlled study including 90 women were subjected for elective cesarean delivery under general anesthesia and were divided at random into 3 equal groups to receive 40 ml bupivacaine (0.25%) + either 2 mg/kg ketamine in (group A), 2 μg/kg dexmedetomidine in (group B) or 2 ml saline in (group C) via local wound infiltration. The primary outcome was time of the first analgesia requested. The secondary outcomes were total dose of analgesia per 24 hours, Visual analogue scale, time of starting movement, breast-feeding, passing flatus or stool, start of eating and adverse effects of medications. Results: A significant increase in time of the first analgesic request in group A (8.4 ±1.91) h. and group B (7.5±1.81) h. than group C (4.3±1.24) h. A significant decrease in pethidine consumption in group A (59 ± 28.93 mg) than group B (72 ± 23.1 mg) and group C (102 ±16 mg). The visual analogue scale (VAS) was significantly lower (p <0.001) in groups A and B than in group C. The time of start movement, breast-feeding, passing flatus and eating was decreased in groups A and B than in group C Conclusions: Addition of ketamine or dexmedetomidine to local anesthetics wound infiltration increased time to the first analgesia request and decreased total analgesic consumption, but ketamine is superior.Nourhan R. BiomyAsmaa FathelbabAmina Abdel-FattahAbeer E. FarhatAl-Azhar University, Faculty of Medicine (Damietta)articleketaminedexmedetomidinelocal anesthesiawound infiltrationMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 3, Pp 1570-1575 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ketamine dexmedetomidine local anesthesia wound infiltration Medicine (General) R5-920
spellingShingle	ketamine dexmedetomidine local anesthesia wound infiltration Medicine (General) R5-920 Nourhan R. Biomy Asmaa Fathelbab Amina Abdel-Fattah Abeer E. Farhat Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section
description	Background: Cesarean delivery is a frequently obstetric operation in Egypt with a recently reported over all cesarean section rate of 54% and it causes moderate to severe postoperative discomfort. Infiltration of the wound site is a method to improve postoperative analgesia. The aim of the work: To compare the pain relief effects of ketamine versus dexmedetomidine combined to bupivacaine in local wound infiltration in patients underwent cesarean section and to estimate side effects of medications. Patients and Methods: This randomized, controlled study including 90 women were subjected for elective cesarean delivery under general anesthesia and were divided at random into 3 equal groups to receive 40 ml bupivacaine (0.25%) + either 2 mg/kg ketamine in (group A), 2 μg/kg dexmedetomidine in (group B) or 2 ml saline in (group C) via local wound infiltration. The primary outcome was time of the first analgesia requested. The secondary outcomes were total dose of analgesia per 24 hours, Visual analogue scale, time of starting movement, breast-feeding, passing flatus or stool, start of eating and adverse effects of medications. Results: A significant increase in time of the first analgesic request in group A (8.4 ±1.91) h. and group B (7.5±1.81) h. than group C (4.3±1.24) h. A significant decrease in pethidine consumption in group A (59 ± 28.93 mg) than group B (72 ± 23.1 mg) and group C (102 ±16 mg). The visual analogue scale (VAS) was significantly lower (p <0.001) in groups A and B than in group C. The time of start movement, breast-feeding, passing flatus and eating was decreased in groups A and B than in group C Conclusions: Addition of ketamine or dexmedetomidine to local anesthetics wound infiltration increased time to the first analgesia request and decreased total analgesic consumption, but ketamine is superior.
format	article
author	Nourhan R. Biomy Asmaa Fathelbab Amina Abdel-Fattah Abeer E. Farhat
author_facet	Nourhan R. Biomy Asmaa Fathelbab Amina Abdel-Fattah Abeer E. Farhat
author_sort	Nourhan R. Biomy
title	Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section
title_short	Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section
title_full	Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section
title_fullStr	Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section
title_full_unstemmed	Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section
title_sort	ketamine versus dexmedetomidine in local wound infiltration for postoperative pain relief in cesarean section
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/76672bf9b08c4505a4afadceea78f1ef
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Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section

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