Effect Of Low-dose Intravenous Ketamine On Postoperative Pain After Cesarean Section Following Under Spinal Anesthesia In Zewditu Memorial Hospitals Addis Ababa Ethiopia 2021 A Prospective Observational Cohort Study
Background: Cesarean section is common obstetric procedures worldwide. Following cesareanrndelivery, mothers experience moderate to severe pain since postoperative analgesia of spinalrnanesthesia is limited by duration of local anesthesia drug used. Analgesic effect of local rnanesthesia agents could be extended by adding adjuvants like neostigmine, opioid and low dosernof intravenous ketamine. rnObjective: This study was assess effect of low-dose intravenous ketamine on postoperative painrnfollowing cesarean section with spinal anesthesia in Zewditu Memorial Hospital, Ethiopia, 2021rnMethod: Sixty pregnant mothers planned for elective cesarean delivery under spinal anesthesia rnwere involved in this prospective cohort study at zewditu memorial hospital. Participants werernselected by systematic random sampling technique. Numerical rating scale pain score, time to rnrequest first analgesia and total analgesia consumptions were recorded in first 24 hours.rnIndependent sample t- test, Mann–Whitney U-test and a chi-square was used for analysis basedrnon distribution of data. rnResult- Numerical rating scale pain score at 1rnstrn and 2rnndrn hour after surgery was significantlyrndifferent between the groups with p≤ 0.05. But pain score at 6rnthrn, 12rnthrn, 18rnthrn and 24rn insignificant.rnTime to request first analgesia was significantly longer in exposed than Non-exposed group with rnp< .0001.The median(range) of tramadol consumption in 24 hour was 100(100_100) for exposedrnand 150(100_150) for non-exposed which was significant difference between both groups with rn(p- value ˂ .0001). But, diclofenac consumption was not significantly different (p =.576).rnConclusion and Recommendation: Low dose intravenous ketamine (0.25mg/kg) before skin rnincision was extended postoperative first analgesia request by average of 45.5minutes andrndecrease total analgesia consumption in 24 hours. Based on this we recommend use of low dosernketamine as a part of postoperative pain treatment.