Abstract

Introduction: After a lower segment caesarean section, local anaesthetic wound infiltration is used as part of multimodal analgesia to lessen pain and opiate use (LSCS). Ketamine extends the effects of analgesia by blocking additional spinal pain pathways.
Aims: To compare the analgesic effectiveness of ketamine and levobupivacaine when injected into subcutaneous wounds.
Materials and Methods: 50 patients receiving under spinal anaesthetic, a randomisedwas done. Both Group A and Group B parturients received surgical wound infiltration with 0.5% levobupivacaine diluted with normal saline at a dose of 2 mg/kg body weight for Group A, and 0.5% levobupivacaine with ketamine at a dose of 1 mg/kg body weight for Group B. We evaluated postoperative pain scores, first rescue analgesia time (FRA), hemodynamic parameters, and overall opioid analgesic use.
Results: Group B had a 1.5-hour longer pain-free duration and shorter time to FRA, along with lower mean VAS scores. Additionally, Group B participants consumed significantly fewer opioids overall and overall pain levels (P = 0.003). 97% of parturients in Group A and just 50% of those in Group B required rescue analgesia. The patient satisfaction score in Group B was considerably higher (P = 0.009). Between the groups, there was no difference in the frequency of nausea and vomiting (P = 0.5234).
Conclusions: Adding ketamine to levobupivacaine for surgical wound infiltration increases patient satisfaction, prolongs the duration of analgesia, and reduces the need for 24-hour opioid use.