Intravenous ketamine during spinal and general anaesthesia for caesarean section: systematic review and meta-analysis

Acta Anaesthesiologica Scandinavica
M HeesenS Straube

Abstract

Intravenous ketamine has been used during general and regional anaesthesia for caesarean section. No systematic review and meta-analysis on the desired effects and adverse effects of ketamine administration during caesarean section have yet been performed. After a systematic literature search a meta-analysis was conducted with the random effects model. Weighted mean difference (WMD) or risk ratio and 95% confidence intervals (CIs) were computed. Twelve randomised controlled double-blind trials comprising 953 patients were included: seven studies reported on spinal anaesthesia and five on general anaesthesia. Significant differences in the aforementioned outcome variables were found only in the spinal anaesthesia studies. In the spinal anaesthesia studies the time to the first analgesic request was significantly longer in ketamine-treated women, the WMD was 49.36 min (95% CI 43.31-55.41); visual analogue scale pain scores at rest 2 h after surgery were significantly lower. No differences were observed for maternal nausea, vomiting, pruritus, and psychomimetic effects. Only few data were found for neonatal outcomes. We conclude that ketamine enhances post-operative analgesia after caesarean section under spinal anaesthesia. There...Continue Reading

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Citations

Mar 10, 2018·Current Opinion in Anaesthesiology·Patricia Lavand'homme
Jun 22, 2018·The Clinical Journal of Pain·Lisa V Doan, Jing Wang
Feb 11, 2020·International Anesthesiology Clinics·Erica HollandChloe Zera
Jan 21, 2020·British Journal of Anaesthesia·Ryu KomatsuPamela D Flood
Sep 6, 2020·Best Practice & Research. Clinical Obstetrics & Gynaecology·Richard HawkinsEmma Evans
Mar 27, 2021·Journal of Medicine and Life·Mina AlipoorAli Sarkoohi
Apr 13, 2021·International Anesthesiology Clinics·Hon Sen TanAshraf S Habib

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