The Effect of Intravenous Dexamethasone versus Ketamine on Operative Pain in Patients Undergoing Cesarean Section

Background & Objective:  Patients undergoing a caesarean section (CS) frequently experience shoulder pain, which is often neglected. However, there are some recommendations to prevent or relieve this pain. This study examined the effect of intravenous dexamethasone and ketamine on reducing shoulder pain in patients who underwent a CS under spinal anesthesia.  Materials & Methods:  The cohort of this prospective study comprised 231 subjects, all of whom were candidates for a CS during 2016. The patients were evaluated based on the type of medication received. After undergoing spinal anesthesia, the first group received 0.5 mg/kg ketamine intravenously and the second group received 0.1 mg/kg dexamethasone intravenously. The patients in these two groups were compared with a control group made up of patients who had not received any medication. Levels of pain severity during and immediately after, as well as 1 h, 6 h, 12 h, 18 h, and 24 h after the CS, were recorded based on the visual analogue scale (VAS). The amount of pethidine consumed was also documented. Results:  Compared to the control group, the intravenous administration of ketamine and dexamethasone significantly reduced shoulder pain resulted from CS under spinal anesthesia (P<0.05). In addition, the number of pethidine recipients in the control group was significantly higher (P<0.001). Conclusion:  The results showed that prophylactic administration of dexamethasone and ketamine is effective in relieving shoulder pain after a CS.