Study of the analgesic efficacy of epidural ketamine with and without bupivacaine in normal labour

ABSTRACT

There are several methods to alleviate pain during normal labor, ketamine given epidurally may be a reasonable technique. Sixty parturients ASA I or II were selected, epidural catheter was inserted and the patients were allocated into three groups [20 patients each]. Group I received 50 mg ketamine, group II received 10 ml of 0.125% bupivacaine, group III received a combination of ketamine 50 mg and bupivacaine 10 ml of 0.125%. Pain was assessed by visual analogue pain score. Arterial blood pressure, heart rate and ECG were monitored. Duration of analgesia, cervical dilatation, induction delivery interval and Apgar score were assessed. Half the initial dose of analgesics was given either on the patient request and /or during the second stage of labor. Ketamine produced significant analgesia which was prolonged by the use of combination of ketamine and bupivacaine. No patient developed respiratory depression, motor blockade or hypotension. Three patients were sleepy and detached from the environment with the use of ketamine