The Efficacy of low: Dose ketamine for prevention of intraoperative nausea and vomiting during caesarean section under spinal anaesthesia: A comparative study

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Background: Intraoperative nausea and vomiting affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about intraoperative nausea and vomiting (IONV) and several in parturient and cesarean. However, it needs more attention. Ketamine is a potential drug in this procedure. Objective: The main objective of the study was to evaluate the efficacy of low-dose ketamine for prevention of intraoperative nausea and vomiting in caesarean section under spinal anaesthesia. Methods: This comparative study was conducted in Department of Anaesthesiology and ICU in Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh during the period from January 2019 to December 2019. In total 120 patients were randomly allocated into two equal groups: the ketamine group; in which 0.5 mg/kg was infused intravenously in 20 min and the placebo group; in which normal saline was infused. The two groups were given subarachnoid block with local anaesthetic hyperbaric 0.5% bupivacaine and intrathecal fentanyl. Results: The incidence of intraoperative nausea was 20% and episodes were 38 in total in the ketamine group compared with 38.33% and episodes were 76 in total in the placebo group, which was statistically significant (P value 0.176). Both vomiting episodes and number of patients who required rescue anti-emetics in the ketamine group compared with placebo one (3.33% vs 6.67% and 2 vs 5 respectively) were not statistically significant P values 0.682 and 0.593. Conclusion: In our study, we found the satisfactory efficacy and better compliance from the patient’s front. Ketamine may be used without hesitation for prevention of intraoperative nausea and vomiting in caesarean section under spinal anaesthesia.