Abstract:

Objectives
In this work we evaluate the effect of addingS(+) ketamine to hyperbaric bupivacaine during spinal anesthesia for cesarean section as regards hypotension, bradycardia, duration of block, postoperative analgesia, side effects and Apgar scores
Materials and methods
Sixty patients scheduled for cesarean section under spinal anesthesia were studied in aprospective double-blinded randomized manner. Group A: 20 patients received 10 mg hyperbaric bupivacaine and another syringe contained normal saline considered the control group. Group B: 20 patients received 10 mg hyperbaric bupivacaine and another syringe contained 0.1 mg/kg S(+)katamine. Group C: 20 patients received 10 mg hyperbaric bupivacaine and another syringe contained 0.25 mg/kg S(+)katamine.

Results
The incidence of spinal hypotension and bradycardia is lower in S(+) ketamine groups,the duration of post operative sensory blockade is more prolonged in S(+)ketamine groups and there is decrease in the incidence of shivering in S(+) ketamine groups with no difference regarding motor blockade and Apgar scores.
Conclusion
S(+)Ketamine added to hyperbaric bupivacaine in spinal anesthesia for cesarean section provides more hemodynamic stability and prolongs the duration of postoperative analgesia with no prolongation of motor blockade besides a lower incidence of shivering.