Effect of Subanesthetic Dose of Ketamine Compare with Morphine and Diazepam in Patients Undergo Postpartum Tubal Ligation under Local Anesthesia
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Abstract
Background: The use of opioid in postpartum tubal ligation (TR) patients can result in delayed gastric emptying time, and thereby increasing the aspiration risk. Opioid is also associated with sedation, respiratory depression as well as nausea and vomiting. A subanesthetic dose of ketamine can reduce pain and postoperative opioid used with no respiratory depression. The objective of the study is to compare the analgesic effect of subanesthetic dose of ketamine with morphine and diazepam in patients undergoing tubal ligation under local anesthesia. Methods: This study was a double-blinded randomized controlled trial. Forty patients underwent tubal ligation under local anesthesia with 2% lidocaine with epinephrine 20 ml were randomly assigned into two groups. Group S received ketamine 0.3 mg/kg iv. Group C received morphine 0.1 mg/kg iv and diazepam 5 mg iv. Results: Mean of numerical rating scale (NRS) in group S was 2.3±1.8 which was significantly less than group C (4.7±1.6). NRS while tying the fallopian tubes, TR1 and TR2 in group S were 2.5±2.9, 4.5±3.7 which less than group C 5.6±2.1, 6.7±1.9, significantly (P=0.0006, 0.0214). However, there was no difference in mean NRS at postoperative period. Conclusion: The use of subanesthetic dose of ketamine (0.3 mg/kg iv) provides greater intraoperative analgesia than the use of morphine and diazepam in patients undergoing postpartum tubal ligation under local anesthesia.
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