Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia

Background: This study aimed to compare the preemptive effect of intravenous ketorolac and ketamine on decreasing the pain of patient in cesarean surgeries. Methods: In a clinical trial study, 150 patients undergoing cesarean surgery were selected and randomly divided into three equal groups of the...

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Main Authors: Azadeh Bahadori, Anahita Hirmanpour, Milad Nilchi
Format: Article
Language:fas
Published: Vesnu Publications 2018-03-01
Series:مجله دانشکده پزشکی اصفهان
Subjects:
Online Access:http://jims.mui.ac.ir/index.php/jims/article/view/9104
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spelling doaj-ac14f29e7a494c03bd21a5f2124eea212020-11-25T01:12:53ZfasVesnu Publications مجله دانشکده پزشکی اصفهان1027-75951735-854X2018-03-01354631931194010.22122/jims.v35i463.91042788Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal AnesthesiaAzadeh Bahadori0Anahita Hirmanpour1Milad Nilchi2Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranAssistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranStudent of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranBackground: This study aimed to compare the preemptive effect of intravenous ketorolac and ketamine on decreasing the pain of patient in cesarean surgeries. Methods: In a clinical trial study, 150 patients undergoing cesarean surgery were selected and randomly divided into three equal groups of the ketorolac, ketamine, and placebo. A stat dose of 15 mg ketorolac, continuing as 10 mg/hour till end of the surgery, a stat dose of 0.25 mg/kg ketamine continuing as 10 mg/hour till end of the surgery, and the same amount of normal saline was injected in the three groups, respectively. Postoperative pain intensity, analgesic requirement, hemodynamic changes during and after surgery, and adverse effects were compared between the three groups. Findings: The mean score of postoperative pain in ketorolac group was significantly lower in the return time of motor block, and 4, 12, and 24 hours later than ketamine and at 4, 12, 24 hours than placebo group (P < 0.05 for all). Mean systolic blood pressure was lower in ketorolac group in different periods of surgery and in recovery period (P < 0.05). Mean diastolic blood pressure was lower in ketorolac group in different periods during the surgery (P < 0.05), but ketamine group had lower diastolic blood pressure in recovery period (P < 0.05). Incidence of hypotension, respiratory depression, cardiac arrhythmia, and hallucination were equal in three groups; but flushing, shiver, and nausea and vomiting were lower in ketorolac group (P < 0.05). Conclusion: Injection of ketorolac as preemptive treatment could decrease postoperative pain intensity in patients who undergo cesarean surgery. It also has some cardiovascular protective effect and decrease incidence of flushing, shiver, and nausea and vomiting after surgery. So, we recommend preemptive use of ketorolac in cesarean surgeries.http://jims.mui.ac.ir/index.php/jims/article/view/9104PainCesarean sectionKetorolacKetamine
collection DOAJ
language fas
format Article
sources DOAJ
author Azadeh Bahadori
Anahita Hirmanpour
Milad Nilchi
spellingShingle Azadeh Bahadori
Anahita Hirmanpour
Milad Nilchi
Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia
مجله دانشکده پزشکی اصفهان
Pain
Cesarean section
Ketorolac
Ketamine
author_facet Azadeh Bahadori
Anahita Hirmanpour
Milad Nilchi
author_sort Azadeh Bahadori
title Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia
title_short Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia
title_full Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia
title_fullStr Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia
title_full_unstemmed Evaluation of the Preemptive Administration of Venous Ketamine or Ketorolac on Pain Relief after Cesarean Section under Spinal Anesthesia
title_sort evaluation of the preemptive administration of venous ketamine or ketorolac on pain relief after cesarean section under spinal anesthesia
publisher Vesnu Publications
series مجله دانشکده پزشکی اصفهان
issn 1027-7595
1735-854X
publishDate 2018-03-01
description Background: This study aimed to compare the preemptive effect of intravenous ketorolac and ketamine on decreasing the pain of patient in cesarean surgeries. Methods: In a clinical trial study, 150 patients undergoing cesarean surgery were selected and randomly divided into three equal groups of the ketorolac, ketamine, and placebo. A stat dose of 15 mg ketorolac, continuing as 10 mg/hour till end of the surgery, a stat dose of 0.25 mg/kg ketamine continuing as 10 mg/hour till end of the surgery, and the same amount of normal saline was injected in the three groups, respectively. Postoperative pain intensity, analgesic requirement, hemodynamic changes during and after surgery, and adverse effects were compared between the three groups. Findings: The mean score of postoperative pain in ketorolac group was significantly lower in the return time of motor block, and 4, 12, and 24 hours later than ketamine and at 4, 12, 24 hours than placebo group (P < 0.05 for all). Mean systolic blood pressure was lower in ketorolac group in different periods of surgery and in recovery period (P < 0.05). Mean diastolic blood pressure was lower in ketorolac group in different periods during the surgery (P < 0.05), but ketamine group had lower diastolic blood pressure in recovery period (P < 0.05). Incidence of hypotension, respiratory depression, cardiac arrhythmia, and hallucination were equal in three groups; but flushing, shiver, and nausea and vomiting were lower in ketorolac group (P < 0.05). Conclusion: Injection of ketorolac as preemptive treatment could decrease postoperative pain intensity in patients who undergo cesarean surgery. It also has some cardiovascular protective effect and decrease incidence of flushing, shiver, and nausea and vomiting after surgery. So, we recommend preemptive use of ketorolac in cesarean surgeries.
topic Pain
Cesarean section
Ketorolac
Ketamine
url http://jims.mui.ac.ir/index.php/jims/article/view/9104
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