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Current Reviews in Clinical and Experimental Pharmacology

Editor-in-Chief

ISSN (Print): 2772-4328
ISSN (Online): 2772-4336

Clinical Trial

Effects of ADJUVANT Ketamine on Induction of Anesthesia for the Cesarean Section

Author(s): Mahmoudreza Moradkhani, Paridokht Hejri*, Sedigheh Nadri and Siavash Beiranvand

Volume 16, Issue 2, 2021

Published on: 10 March, 2020

Page: [197 - 200] Pages: 4

DOI: 10.2174/1574884715666200310103317

Price: $65

Abstract

Background: The cesarean section has shown an increasing trend within the past few years. The use of appropriate and effective anesthesia for the procedure is important, not only to reduce the incidence of maternal and fetal morbidities but also to reduce the incidence of intraoperative consciousness. The aim of this study is to evaluate the intraoperative and postoperative effects of adjuvant ketamine, when used in combination with general anesthesia.

Methods: The study was conducted on the patients referred to Asali hospital for the cesarean section. 100 patients were assigned into two groups. Patients in Group A received thiopental (4 mg / kg) as an anesthetic agent for the surgery, whereas those in group B received thiopental along with 0.5 mg/kg of intravenous ketamine. The effects of ketamine, such as depth of anesthesia, intraoperative and postoperative awareness, vomiting and hallucination were recorded in the questionnaire and data were statistically analyzed using SPSS v25.

Results: Of 100 patients in group A, 10 of them were not deeply unconscious. 40 patients in group A and 25 in group B had intraoperative awareness. Depth of anesthesia was significantly associated with the use of ketamine (p = 0.0017) 1 patient in group A and 3 in group B had vomiting and 1 patient in group B was presented with the hallucinations. These parameters were not significantly associated with the dose of ketamine (p = 0.5).

Conclusion: Overall use of ketamine is associated with better sedation and no significant side effects, with low doses of ketamine, were seen in our study. Comparative studies using other analgesics, with larger sample size, are therefore recommended.

Keywords: Ketamine, deep unconsciousness, hallucination, sedation, anesthesia, cesarean section.

Graphical Abstract
[1]
Baraka AS, Sayyid SS, Assaf BA. Thiopental-rocuronium versus ketamine-rocuronium for rapid-sequence intubation in parturients undergoing cesarean section. Anesth Analg 1997; 84(5): 1104-7.
[http://dx.doi.org/10.1213/00000539-199705000-00027] [PMID: 9141939]
[2]
Lorzadeh N, Kazemirad S, Lorzadeh M. Urinary retention following the gynecologic surgeries and effect of Foley catheter clamping on its prophylaxis. J Med Sci 2007; 7(8): 1358e61.
[3]
Lorzadeh N, Kazemirad S, Lorzadrh M, Dehnori A. A comparison of human chorionic gonadotropin with magnesium sulphate in inhibition of preterm labor. J Med Sci 2007; 7(4): 640-4.
[http://dx.doi.org/10.3923/jms.2007.640.644]
[4]
Lorzadeh N, Samimi S, Birjandi M. Association of fetal gender with maternal serum β-hCG and testosterone in normotensive and preeclamptic pregnancies. Majallah-i Zanan, Mamai va Nazai-i Iran 2010; 13(1): 13-9.
[5]
Maharlouei N, Moalaee M, Ajdari S, Zarei M, Lankarani KB. Caesarean delivery in south-western Iran: Trends and determinants in a community-based survey. Med Princ Pract 2013; 22(2): 184-8.
[http://dx.doi.org/10.1159/000341762] [PMID: 22922349]
[6]
Schultetus RR, Paulus DA, Spohr GL. Haemodynamic effects of ketamine and thiopentone during anaesthetic induction for caesarean section. Can Anaesth Soc J 1985; 32(6): 592-6.
[http://dx.doi.org/10.1007/BF03011404] [PMID: 3907790]
[7]
Moradkhani MR, Karimi A. Role of drug anesthesia and cancer. Drug Res (Stuttg) 2018; 68(3): 125-31.
[http://dx.doi.org/10.1055/s-0043-119071] [PMID: 29161749]
[8]
Alizadeh R, Mireskandari S-M, Azarshahin M, Darabi M-E, Padmehr R, Jafarzadeh A, et al. Oral clonidine premedication reduces nausea and vomiting in children after appendectomy. Iran J Pediatr 2012; 22(3): 399.
[9]
Lorzadeh N, Kazemirad S, Lorzadeh M, Najafi S. Comparison of the effect of oral and intravenous fluid therapy on women with oligohydramnios. Res J Obstet Gynecol 2008; 1(1): 25-9.
[http://dx.doi.org/10.3923/rjog.2008.25.29]
[10]
Beiranvand S, Moradkhani MR. Bupivacaine versus liposomal bupivacaine for pain control. Drug Res (Stuttg) 2018; 68(7): 365-9.
[http://dx.doi.org/10.1055/s-0043-121142] [PMID: 29108087]
[11]
Kurdi MS, Theerth KA, Deva RS. Ketamine: Current applications in anesthesia, pain, and critical care. Anesth Essays Res 2014; 8(3): 283-90.
[http://dx.doi.org/10.4103/0259-1162.143110] [PMID: 25886322]
[12]
Alizadeh R, Aghsaie Fard Z. Renal impairment and analgesia: From effectiveness to adverse effects. J Cell Physiol 2019; 234(10): 17205-11.
[13]
Alizadeh R, Fard ZA. Renal effects of general anesthesia from old to recent studies. J Cell Physiol 2019; 234(10): 16944-52.
[14]
Kim SH, Kim SI, Ok SY, et al. Opioid sparing effect of low dose ketamine in patients with intravenous patient-controlled analgesia using fentanyl after lumbar spinal fusion surgery. Korean J Anesthesiol 2013; 64(6): 524-8.
[http://dx.doi.org/10.4097/kjae.2013.64.6.524] [PMID: 23814653]
[15]
Moradkhani MR, Karimi A. Effect of Artemisia aucheri. L and bupivacaine encapsulated nanoparticles on nociceptive pain. Drug Res (Stuttg) 2019; 69(7): 401-5.
[http://dx.doi.org/10.1055/a-0825-6487] [PMID: 30616248]
[16]
Downing JW, Mahomedy MC, Jeal DE, Allen PJ. Anaesthesia for caesarean section with ketamine. Anaesthesia 1976; 31(7): 883-92.
[http://dx.doi.org/10.1111/j.1365-2044.1976.tb11899.x] [PMID: 9839]
[17]
Tumukunde J, Lomangisi DD, Davidson O, Kintu A, Joseph E, Kwizera A. Effects of propofol versus thiopental on Apgar scores in newborns and peri-operative outcomes of women undergoing emergency cesarean section: A randomized clinical trial. BMC Anesthesiol 2015; 15: 63.
[http://dx.doi.org/10.1186/s12871-015-0044-6] [PMID: 25924776]
[18]
Ahiskalioglu EO, Aydin P, Ahiskalioglu A, et al. The effects of ketamine and thiopental used alone or in combination on the brain, heart, and bronchial tissues of rats. Arch Med Sci 2018; 14(3): 645-54.
[http://dx.doi.org/10.5114/aoms.2016.59508] [PMID: 29765454]
[19]
Moradkhani MR, Karimi A, Negahdari B. Nanotechnology application to Local Anaesthesia (LA). Artif Cells Nanomed Biotechnol 2018; 46(2): 355-60.
[http://dx.doi.org/10.1080/21691401.2017.1313263] [PMID: 28395522]
[20]
Dich-Nielsen J, Holasek J. Ketamine as induction agent for caesarean section. Acta Anaesthesiol Scand 1982; 26(2): 139-42.
[http://dx.doi.org/10.1111/j.1399-6576.1982.tb01741.x] [PMID: 7102236]
[21]
Momenzadeh S, Moradkhani M, Moghadam MH. Low Level Laser Therapy (LLLT) combined with physical exercise, a more effective treatment in low back pain. J Lasers Med Sci 2012; 3(2): 67.
[PMID: 25606309]
[22]
Lorzadeh N, Ghasem Nejad A, Mohmad Pour J. The effect of metformin on outcome of Intrauterine Insemination (IUI) in insulin non-resistant infertile women with polycystic ovarian syndrome. Majallah-i Zanan, Mamai va Nazai-i Iran 2014; 17(128): 1-11.
[23]
Akbariasbagh F, Lorzadeh N, Azmoodeh A, Ghaseminejad A, Mohamadpoor J, Kazemirad S. Association among diameter and volume of follicles, oocyte maturity, and competence in intracytoplasmic sperm injection cycles. Minerva Ginecol 2015; 67(5): 397-403.
[PMID: 26491821]
[24]
Fischer MM. Ketamine hydrochloride in severe bronchospasm. Anaesthesia 1977; 32(8): 771-2.
[http://dx.doi.org/10.1111/j.1365-2044.1977.tb10079.x] [PMID: 920918]
[25]
Bengtsson M. Sensory and sympathetic blockade in connection with intradural and extradural analgesia Local anaesthesia and regional blockade, pharmacology, physiology and clinical effects Amsterdam. Elsevier Science Publications 1988; pp. 105-33.
[26]
Houlton PJ, Downing JW. General anaesthesia with intravenous flunitrazepam, continuous ketamine infusion and muscle relaxant. A preliminary report. S Afr Med J 1978; 54(25): 1048-9.
[PMID: 34234]
[27]
Rudin M, Ben-Abraham R, Gazit V, Tendler Y, Tashlykov V, Katz Y. Single-dose ketamine administration induces apoptosis in neonatal mouse brain. J Basic Clin Physiol Pharmacol 2005; 16(4): 231-43.
[http://dx.doi.org/10.1515/JBCPP.2005.16.4.231] [PMID: 16438390]

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