title: Perioperative low-dose ketamine improves postoperative analgesia following Cesarean delivery with general anesthesia.
abstract: OBJECTIVE
  In this study, the effect of perioperative uses of low dose ketamine on post-operative wound pain and analgesic consumption in patients undergoing elective Cesarean section was evaluated.
  
  
  METHODS
  In randomized, double blind clinical trial, 52 women with American Society of Anesthesiologists (ASA) class I-II identification undergoing elective Cesarean section in general anesthesia were enrolled. In the ketamine group (group K), a ketamine bolus of 0.5 mg kg(-1) IV was administered at the time of induction of general anesthesia. After induction, a ketamine infusion of 0.25 mg kg(-1) h(-1) was started and discontinued at the end of surgery. Patients allocated to the control group (group C) were given identical volumes of saline. The cumulative dose of morphine consumption after surgery was measured as the primary outcome of this study. Secondary outcomes were pain control assessed by numeric rating scale (NRS) and need for rescue analgesia and incidence of side effects.
  
  
  RESULTS
  The mean 24-h morphine consumption was lower in group K (p = 0,001). At 15 min postoperatively, NRS values were lower in group K than group C (p = 0,001). There was no difference among groups regarding the need for supplemental analgesia (rescue diclofenac doses) (p > 0.05).
  
  
  CONCLUSIONS
  Perioperative uses of low dose ketamine decreased post-operative opioid requirements, which was observed long after the normal expected duration of ketamine.
authors.affiliation: a Department of Anaesthesiology and Reanimation , Yeditepe University Faculty of Medicine , İstanbul , Turkey .
authors.forename: Murat
authors.initials: M
authors.lastname: Haliloglu
authors.affiliation: b Department of Anaesthesiology and Reanimation , Umraniye education and Research Hospital , İstanbul , Turkey , and.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Ozdemir
authors.affiliation: a Department of Anaesthesiology and Reanimation , Yeditepe University Faculty of Medicine , İstanbul , Turkey .
authors.forename: Neslihan
authors.initials: N
authors.lastname: Uzture
authors.affiliation: c Department of Obstetrics and Gynecology , Yeditepe University Faculty of Medicine , İstanbul , Turkey.
authors.forename: Pinar Ozcan
authors.initials: PO
authors.lastname: Cenksoy
authors.affiliation: b Department of Anaesthesiology and Reanimation , Umraniye education and Research Hospital , İstanbul , Turkey , and.
authors.forename: Nurten
authors.initials: N
authors.lastname: Bakan
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D000768:Anesthesia, General; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control*; D059035:Perioperative Period; D011247:Pregnancy
chemical_list: D000700:Analgesics; D007649:Ketamine
keywords: Caeserean section; perioperative ketamine; postoperative analgesia