Caspian Journal of Internal Medicine

en The utero-tonic effects of low dose intravenous ketamine in cesarean section under spinal anesthesia; A randomized double-blind clinical trial Anesthesiology Anesthesiology Original Article Original Article Background: Recently, the prevalence of cesarean section (CS) has been on the rise and the proper uterine tone is an important issue. We investigated the effects of intravenous (IV) ketamine on intraoperative bleeding and the need for oxytocin in CS under spinal anesthesia (SA). Methods: This study, took place at Alzahra hospital during 2020. Pregnant women candidate for elective CS under SA were divided into two groups of ketamine and placebo. In group K, after umbilical cord clamping, 0.25 mg/kg ketamine and in group P 2ccs normal saline was injected. Mean arterial pressure and heart rate were recorded at baseline, before and 5 minutes after cord clamping and at the end of the surgery. The drop in hemoglobin values, the administrated units of oxytocin and side effects were also recorded. Results: No significant difference was found in terms of patients’ demographic data (P ≥ 0.05). The mean units of administrated oxytocin in group K was 34.61±6.63 and in group P; 48.47±12.15, which was significantly different (P=0.0001). The drop in Hb was less in group K, however not statistically significant (P=0.094). The need for methergine was significantly higher in group P (P=0.0001). The mean HR was significantly higher in group P (P=0.027), however, no significant difference was observed regarding the MAP (P=0.064). The incidence of hallucination (4.8%) and nystagmus (21%) was significantly higher in group K (P= 0.0001), but nausea and vomiting were more significant in group P (P= 0.027). Conclusion: Prophylactic administration of low-dose ketamine in CS under S.A could significantly reduce the administrated oxytocin units and the need for additional utero-tonics and was associated with less drop in Hb values. Bleeding, Ketamine, Intraoperative Care, Oxytocin 218 225 http://caspjim.com/browse.php?a_code=A-10-1969-7&slc_lang=en&sid=1 Mohammad Haghighi manesthesist@gmail.com 100319475328460041832 100319475328460041832 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran Soheil Soltanipour ssoltanipour@yahoo.com 100319475328460041833 100319475328460041833 No Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Farnoush Farzi Farnoushfarzi1374@gmail.com 100319475328460041834 100319475328460041834 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran Mandana Mansour-Ghanaei m-m-ghanaie@gums.ac.ir 100319475328460041835 100319475328460041835 No Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Gelareh Biazar gelarehbiazar1386@gmail.com 100319475328460041836 100319475328460041836 Yes Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran Azadeh Malekzadeh Azadeh.malakzadeh@gmail.com 100319475328460041837 100319475328460041837 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran Mahin Tayefeh Ashrafiyeh mahintayefe@gmail.com 100319475328460041838 100319475328460041838 No Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran