Effects of Ketamine on the Profile of Cytokines and Bdnf in Maternal and Umbilical Cord Blood During Cesarean Delivery

Objective: Shivering is a frequent and undesirable complication of cesarean section with spinal anesthesia. The present study aimed to determine the effects of ketamine on the levels of cytokines, immunoglobulins and brain-derived neurotrophic factor (BDNF) during cesarean section-mediated perioperative shivering. Methods: In this randomized controlled trial, eighty patients undergoing cesarean section were enrolled. They were randomly allocated to one of two groups: a control group (n = 40) that received normal saline, and a ketamine group (n = 40) that received ketamine at a dose of 0.25 mg/kg. Maternal blood samples were collected at three predefined time points: after study drug administration (T1), after umbilical cord clamping (T2), and at the end of surgery (T3). Results: At the T2 time point, the ketamine group exhibited a significant reduction in maternal cytokine concentrations compared to the saline control. Umbilical cord immunoglobulin concentrations were comparable between groups. Moreover, no correlation was found between umbilical cord BDNF and maternal cytokine levels at T2. Conclusions: Ketamine alleviated cesarean section-mediated perioperative shivering via diminishing cytokines, without impacting the levels of BDNF or immunoglobulins. Moreover, ketamine treatment decreased the levels of cytokines in the maternal blood; thus, abrogating the risk of transferal into the neonate.