Подкожная инфильтрация раны кетамином по сравнению с бупивакаином в восприятии боли и потреблении опиоидов после кесарева сечения: рандомизированное контролируемое исследование

Relevance: Pain after cesarean delivery can be difficult to control and may require additional medication. Since opioids are associated with several unwanted effects, other methods of pain relief are being explored. While intravenous and intrathecal ketamine have been studied extensively, the analgesic role of subcutaneous ketamine infiltration at the surgical wound site remains under-investigated. The study aimed to evaluate the analgesic efficacy and safety of subcutaneous ketamine infiltration compared to bupivacaine and placebo in women undergoing elective cesarean section under spinal anesthesia. Materials and Methods: A prospective, randomized, controlled trial was conducted at Kasr Al-Ainy University Hospital, Egypt, involving 120 parturients scheduled for elective cesarean section. Participants were randomized equally into three groups (n = 40 each): ketamine (1 mg/kg), bupivacaine (20 mL of 0.5% bupivacaine), or control (no wound infiltration). The allocated medication was infiltrated subcutaneously along the surgical wound immediately before skin closure. We assessed postoperative pain using the Visual Analog Scale (VAS) at 15 minutes, 60 minutes, 2 hours, 6 hours, 12 hours, and 24 hours after surgery.