Journal of Obstetric Anaesthesia and Critical Care

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 9  |  Issue : 2  |  Page : 60--64

Comparison of levobupivacaine alone versus levobupivacaine with ketamine in subcutaneous infiltration for postoperative analgesia in lower segment cesarean section


Paridhi Kaler1, Indu Verma2, Anju Grewal3, Ashima Taneja4, Dinesh Sood3 
1 Department of Anaesthesia, AIIMS, Delhi, India
2 Department of Obstetrics, CMCH, Ludhiana, Punjab, India
3 Department of Anaesthesia, DMCH, Ludhiana, Punjab, India
4 Department of Obstetrics, DMCH, Ludhiana, Punjab, India

Correspondence Address:
Dr. Paridhi Kaler
56 F, Rishi Nagar, Ludhiana - 141 001, Punjab
India

Context: Local anesthetic wound infiltration is employed as a part of multimodal analgesia to reduce opiate consumption and pain after lower segment cesarean section (LSCS). Additional blockade of pain pathway at spinal level by ketamine prolongs the duration of analgesia. Aims: To compare analgesic efficacy of subcutaneous wound infiltration of levobupivacaine or levobupivacaine plus ketamine following LSCS. Material and Methods: Randomized double blind study was conducted on 60 parturients undergoing LSCS under spinal anesthesia. Group A received surgical wound infiltration with 0.5% levobupivacaine 2 mg/kg body weight and Group B parturients were infiltrated with 0.5% levobupivacaine plus ketamine 1 mg/kg body weight diluted with normal saline. Postoperative pain scores, time to first rescue analgesia (FRA), hemodynamic parameters, and total opioid analgesic consumption were assessed. Results: Pain free period and time to FRA was 1.5 hours later in group B, which also had reduced mean VAS scores. In addition, the overall pain scores and total opioid consumption were significantly less (P = 0.003) in Group B. Only 50% in Group B and 97% parturients in Group A needed rescue analgesia. Patient satisfaction score was statistically superior in Group B (P = 0.009). Incidence of nausea and vomiting was comparable between the groups (P = 0.554). Conclusions: Addition of ketamine to levobupivacaine for surgical wound infiltration prolongs the analgesia duration, improves patient satisfaction, and decreases 24-hour opioid consumption.


How to cite this article:
Kaler P, Verma I, Grewal A, Taneja A, Sood D. Comparison of levobupivacaine alone versus levobupivacaine with ketamine in subcutaneous infiltration for postoperative analgesia in lower segment cesarean section.J Obstet Anaesth Crit Care 2019;9:60-64


How to cite this URL:
Kaler P, Verma I, Grewal A, Taneja A, Sood D. Comparison of levobupivacaine alone versus levobupivacaine with ketamine in subcutaneous infiltration for postoperative analgesia in lower segment cesarean section. J Obstet Anaesth Crit Care [serial online] 2019 [cited 2019 Sep 17 ];9:60-64
Available from: http://www.joacc.com/article.asp?issn=2249-4472;year=2019;volume=9;issue=2;spage=60;epage=64;aulast=Kaler;type=0