A comparative study of low dose ketamine versus magnesium sulfate for local wound infiltration after cesarean section | ||
| Minia Journal of Medical Research | ||
| Volume 30, Issue 1, March 2019, Pages 72-77 PDF (171.97 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mjmr.2022.222778 | ||
| Authors | ||
| Mohamed S. Mohamed; Amr N. Abd El-Razik; Nourhan A. Abd El-Ghani | ||
| Department of Anesthesia and Intensive Care Unit , Faculty of Medicine, Minia University | ||
| Abstract | ||
| Introduction: Spinal anesthesia is the safest during lower abdominal operations. Long-acting local anesthetics administered to the wound site or under the skin after surgery have been demonstrated to be effective for postoperative analgesia. The infiltration of wounds with local anesthetics seems not only to provide analgesia. It may also help to reduce the up-regulation of peripheral nociceptors that manifest as increased sensitivity to pain. It has been suggested that regional anesthetic techniques can reduce the postoperative stress response. Some additives to local anesthetics can hasten the onset of nerve block, prolong block duration, or reduce toxicity. Magnesium has been used as an effective adjuvant in postoperative pain and as its role as a physiological blocker of NMDA receptors in the sensitization process and hyperalgesia suppression. Another NMDA antagonist, Ketamine, has been raised to not only alleviate the patients’ pain but also to lessen their needs for systemic opioids. Methods: A total of 100 parturients underwent elective Caesarean sections were randomized into two equal groups of 50 patients each using the computer-generated table. Ketamine group(K) received postoperative incisional local infiltration with a total volume of 20 ml of 10 ml bupivacaine 0.5%, 25 mg ketamine (0.5 ml) plus saline 0.9% (9.5 ml) and magnesium sulfate group(M) who received postoperative incisional local infiltration with a total volume of 20 ml of 10 ml bupivacaine 0.5 %, 750 magnesium sulfate (7.5 ml) plus saline 0.9% (2.5 ml). Results: We found that the use of magnesium sulfate in a dose of (750 mg) as an adjuvant to bupivacaine provided better postoperative analgesia than the usage of low dose ketamine in a dose of (25 mg) as an adjuvant to bupivacaine in subcutaneous infiltration in the cesarean wound . | ||
| Keywords | ||
| cesarean section; bupivacaine; ketamine; local wound infiltration; magnesium sulfate; postoperative analgesia; postoperative pain | ||
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