Effect of Local Wound Infiltration with Ketamine versus Dexmedetomidine on Post-operative Pain Relief in Terms of Quality and Duration after Cesarean Section

Objective: To measure the frequency of pain and duration of analgesia with two different adjuvants (ketamine & dexmedetomidine) with local anesthetic bupivacaine for local wound infiltration after cesarean section for post-operative analgesia. Study Design: Randomized Controlled Trial (IRCT: 74668). Place and Duration of Study: Anesthesia department, Pakistan Air Force Hospital, Karachi Pakistan, from Jul to Dec 2023. Methodology: The study was commenced after permission from the ethical committee with ERC number FRPMC-IRB-2023-03 & trial registration number#74668 9 (IRCT). It was a single center study and a sample of 142 was randomized into two groups: Groups A and B. In group A ketamine was employed as an adjuvant and in group B dexmedetomidine was used as an adjuvant. Quality of analgesia and duration of block was measured post-operatively in both groups to compare the drug under study. Results: Twenty-seven (39.7%) of group B patients had mild pain and 41(60.3%) experienced moderate pain at 12 hours. Thirty-nine (54.9%) group A patients developed moderate pain while 32(45.1%) experienced severe pain necessitating rescue analgesia after twelve hours of surgery. The mean time to first rescue analgesia was also prolonged on group B patients with mean duration of analgesia in group B to be 15.49±3.2 hours versus 8.4±4.1 hours in group A with p-value of <0.001. Conclusion: We concluded that dexmedetomidine was favorable adjuvant in terms of quality and duration of analgesia for local wound infiltration compared to ketamine.