Effect of Dexamethasone versus Low Dose Ketamine on Post Spinal Hypotension in Caesarian Section

Abstract Background Spinal anesthesia is the preferred method for elective cesarean sections due to considerable risks regarding airway management associated with physiological changes of pregnancy. Cesarean sections normally require an anesthetic block at T4 level, so hypotension is reported in up to 80% of spinal anesthesia cases. Aim of the Work To assess the effect of prophylactic sub-anesthetic dose of ketamine versus the effect of Dexamesathone to prevent maternal hypotension after spinal anaesthesia in cesarean section. Patients and Methods This study is a randomized controlled study this study done in obstetrics and Gynecology Department, Ain Shams hospitals at 3 months and the females undergoing caesarian section under spinal anesthesia. Results The study revealed that ketamine group showed significant lower incidence of postspinal hypotension compared to the control group 5, 10, 15, 20 minutes. Whereas the dexamethasone group showed significant reduction in incidence of postspinal hypotension when compared to the control group only at the first 5 minutes, while comparing both ketamine and dexamethasone groups the incidence of hypotension was not significant. Also, observed that total ephidren dose significantly decreased in ketamine group compared to control group. And sedation scores in the first 30 min were higher in ketamine group. HR wasn’t affected. No changes in APGAR score were noticed between the two groups. No side effects from ketamine except for nystagmus. Conclusion the randomized controlled study conducted in the Obstetrics and Gynecology Department at Ain Shams hospitals investigated the effects of dexamethasone and low-dose ketamine on post-spinal hypotension in caesarean deliveries. The study compared three groups: a ketamine group, a dexamethasone group, and a control group.