Different Doses of Ketamine in Preventing Chills in Pregnant Lady with Caesarean Section Under Spinal Anesthesia

Dr. Orooba Mezher  Hasan; Dr. Eman Sahib  Mahdi; Dr. enaam yahya  ebraheem

Dr. Orooba Mezher Hasan C.A.B.M.S anesthesiologist and intensive care, anesthesiologist and intensive care spacialist in AL sader teaching hospital, Mesaan, Iraq
Dr. Eman Sahib Mahdi FICMS anesthesiologist and intensive care, Anesthesiologist and intensive care specialist in AL zahraa teaching hospital, Alnajaf alashraf
Dr. enaam yahya ebraheem FICMS anesthesiologists and intensive care. Anesthesiologists and intensive care specialist in Imam sadiq teaching hospital

Keywords: Pregnant Lady, Spinal Anesthesia

Abstract

Aim of the study:

To compare the efficacy and safety of ketamine 0.25 mg/kg versus ketamine 0.5 mg/kg in the prevention of chills in patients undergoing caesarean section.

design: a prospective, randomized, double-blind, placebo-controlled study. In AL sader teaching hospital Mesaan .Iraq, and AL zahraa teaching hospital / Alnajaf alashraf.

patients: 120 pregnant women 1 and 2 in ASA body status who underwent cesarean section during spinal anesthesia.

procedures

Measurements: Patient characteristics, anesthesia and surgical details, 1 and 5 minute Apgar scores, and study drug side effects were recorded. Heart rate, mean arterial pressure, oxygen saturation by pulse oximetry, eardrum temperature, chills, and degree of sedation were recorded before intrathecal injection and every 5 minutes thereafter. Patients were randomized into three groups: saline (Group C, n=30), intravenous (IV) ketamine 0.25 mg/kg (Group K-0.25, n=30) or intravenous ketamine 0.5 mg/kg (group K-0.5, n=30). Grade 3 or 4 tremor was treated with 25 mg intravenous meperidine and prophylaxis was considered ineffective.

Main Results: The number of patients with chills was significantly lower in the group 0.25 and in group K-0.5, compared to group C (P=0.001, P=0.001). Group C's eardrum temperatures were lower than both ketamine groups during the study. The mean sedation scores in the K-0.5 group were significantly higher than in the K-0.25 group or the C group at 10, 20, 30, and 40 minutes after spinal anesthesia.

Conclusion: Prophylactic IV ketamine 0.25 mg/kg was as effective as IV ketamine 0.5 mg/kg of prevents tremors in patients undergoing caesarean section under spinal anesthesia.

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