Effect of Local Wound Infiltration with Ketamine versus Dexmedetomidine on Post-operative Pain Relief in Terms of Quality and Duration after Cesarean Section

Zainab Afzal; Zahid Akhtar  Rao; Syed  Sameuddin; Muhammad  Khalid; Muhsan Sultan; Adil Mehraj

doi:10.51253/pafmj.v75iSUPPL-2.11742

Authors

Zainab Afzal Department of Anesthesia, Fazaia Ruth Pfau Medical College, Karachi Pakistan
Zahid Akhtar Rao Department of Anesthesia, Fazaia Ruth Pfau Medical College, Karachi Pakistan
Syed Sameuddin Department of Anesthesia, Fazaia Ruth Pfau Medical College, Karachi Pakistan
Muhammad Khalid Department of Anesthesia, Fazaia Ruth Pfau Medical College, Karachi Pakistan
Muhsan Sultan Department of Anesthesia, Fazaia Ruth Pfau Medical College, Karachi Pakistan
Adil Mehraj Department of Anesthesia, Fazaia Ruth Pfau Medical College, Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-2.11742

Keywords:

Dexmedetomidine, Ketamine, Lower Segment Cesarean Section (LSCS).

Abstract

Objective: To measure the frequency of pain and duration of analgesia with two different adjuvants (ketamine & dexmedetomidine) with local anesthetic bupivacaine for local wound infiltration after cesarean section for post-operative analgesia.

Study Design: Randomized Controlled Trial (IRCT: 74668).

Place and Duration of Study: Anesthesia department, Pakistan Air Force Hospital, Karachi Pakistan, from Jul to Dec 2023.

Methodology: The study was commenced after permission from the ethical committee with ERC number FRPMC-IRB-2023-03 & trial registration number#74668 9 (IRCT). It was a single center study and a sample of 142 was randomized into two groups: Groups A and B. In group A ketamine was employed as an adjuvant and in group B dexmedetomidine was used as an adjuvant. Quality of analgesia and duration of block was measured post-operatively in both groups to compare the drug under study.

Results: Twenty-seven (39.7%) of group B patients had mild pain and 41(60.3%) experienced moderate pain at 12 hours. Thirty-nine (54.9%) group A patients developed moderate pain while 32(45.1%) experienced severe pain necessitating rescue analgesia after twelve hours of surgery. The mean time to first rescue analgesia was also prolonged on group B patients with mean duration of analgesia in group B to be 15.49±3.2 hours versus 8.4±4.1 hours in group A with p-value of <0.001.

Conclusion: We concluded that dexmedetomidine was favorable adjuvant in terms of quality and duration of analgesia for local wound infiltration compared to ketamine.

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