Résumé
Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for the prevention of shivering caused by spinal anesthesia, during lower segment cesarean section
Main Outcome Measures: Heamodynamic monitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction
Design: Prospective Randomized Controlled trial
Place: Department of Anesthesia and ICU PNS Shifa Karachi
Duration of study: March 2010 to June 2010
Patients and Methods: 100 ASA-I and II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study, patients were randomly allocated to receive ketamine alone [Group I, n= 50], and ketamine plus midazolam [Group II, n = 50]. After standardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes
Results: Shivering was observed in 9/50 [18%] patients of group I [Ketamine only] as compared to only 2/50 [4%] patients in Group II [ketamine + midazolam] [p=0.025] which is statically significant. The two groups were comparable regarding distribution of age [p=0.37], BMI [p=0.27] and duration of surgery. Results were analyzed by using chi square test
Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdose i.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia