Background: Indeed, local anesthetic infiltration of surgical wounds is a straightforward, effective, and inexpensive approach of providing excellent postoperative analgesia for a wide range of surgical operations with minimal risk of adverse consequences.
Objective: The purpose of this study was to evaluate the efficacy of bupivacaine, bupivacaine combined with dexmedetomidine, or ketamine for post-operative analgesia following caesarean delivery.
Subjects and Methods:A total of 90 pregnant womenscheduled for elective cesarean section, were equally divided into 3 equal groups (thirty each); control (C) group: received local wound infiltration with 40 mL of 0.25% bupivacaine (20 ml bupivacaine 0.5 %- and 20-ml saline) in two divided doses; dexmedetomidine (D) group: received local wound infiltration with a volume of forty mL of 0.25% bupivacaine plus 2 ug/kg dexmedetomidine; and ketamine (K) group: Patients had volume-specific local wound infiltration with forty ml of 0.25% bupivacaine plus 2 mg/kg ketamine.
Results: When compared to the other two groups, the ketamine group had a significantly longer duration before they needed analgesia (P < 0.001). Morphine consumption in the ketamine group was much lower than in the other two groups. (P < 0.001). The ketamine group had the most satisfied patients compared to the other two (P < 0.001).
Conclusion: It could be concluded that adding ketamine with bupivacaine in wound infiltration has a better effect than adding dexmedetomidine as regards hemodynamics stability, the time to the first analgesic request, patients' satisfaction, and the total dose of morphine consumption during the 24 hours post operatively.