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A double-blind comparison of intrathecal S(+) ketamine and fentanyl combined with bupivacaine 0.5% for Caesarean delivery

Published online by Cambridge University Press:  07 July 2006

H. Unlugenc ,
M. Ozalevli ,
Y. Gunes ,
S. Olguner ,
C. Evrüke ,
D. Ozcengiz  and
H. Akman
H. Unlugenc
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
M. Ozalevli
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
Y. Gunes
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
S. Olguner
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
C. Evrüke
Affiliation:
Cukurova University, Faculty of Medicine, Department of Gynecology and Obstetric, Adana, Turkey
D. Ozcengiz
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
H. Akman
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
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Abstract

Summary

Background: In this prospective, randomized, double-blind, controlled study, we investigated the sensory, motor and analgesic block characteristics of S(+) ketamine, fentanyl and saline given intrathecally (IT) in addition to 0.5% plain bupivacaine (10 mg) for spinal analgesia. Methods: Ninety ASA I or II adult patients undergoing Caesarean section were randomly allocated to receive 1.0 mL of 0.9% saline in Group S (n = 30), 0.05 mg kg−1 of S(+) ketamine (1.0 mL) in Group K (n =30) or 25 μg (1.0 mL) of fentanyl in Group F (n =30) following 10 mg of plain bupivacaine 0.5% IT. We recorded onset and duration of sensory and motor block, time to reach the maximal dermatomal level of sensory block and duration of spinal analgesia. Results: The onset time of sensory and motor block was significantly shorter in Groups K and F than in Group S (P < 0.014). Their duration was significantly longer in Group F than in Groups K and S (P < 0.009). The time to reach the maximal dermatomal level of sensory block was significantly shorter in Groups K and F than in Group S (P < 0.001). The duration of spinal analgesia was significantly longer in Group F than in Groups K and S (P < 0.001). Conclusion: In patients undergoing Caesarean section with spinal analgesia, the addition of S(+) ketamine (0.05 mg kg−1) IT to 10 mg of spinal plain bupivacaine (0.5%) led to rapid onset of both sensory and motor blockade and enhanced the segmental spread of spinal block without prolonging the duration of spinal analgesia, whereas fentanyl provided prolonged analgesia.

Keywords

ANAESTHETICS, INTRAVENOUS, ketamineLOCAL ANAESTHETICS, bupivacaineANALGESICS, OPIOID, fentanylSPINAL ANAESTHESIA
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 12 , December 2006 , pp. 1018 - 1024
Copyright
2006 European Society of Anaesthesiology

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