Background. Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative\npain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit.We determined ketamineââ?¬â?¢s\npostoperative analgesic effects. Materials and Methods. We did an RCT among consenting parturients that were randomized to\nreceive either intravenous ketamine (0.25mg/kg) or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24\nhours postoperatively using the numerical rating scale.The first complaint of pain requiring treatment was noted as ââ?¬Å?time to first\nbreakthrough pain.ââ?¬Â Results. We screened 100 patients and recruited 88 that were randomized into two arms of 44 patients that\nreceived either ketamine or placebo. Ketamine group had 30-minute longer time to first breakthrough pain and lower 24-hour pain\nscores. Postoperative diclofenac consumption was lesser in the ketamine group compared to placebo and Kaplan-Meier graphs\nshowed a higher probability of experiencing breakthrough pain earlier in the placebo group. Conclusion. Preincision intravenous\nketamine (0.25mg/kg) offered 30-minute prolongation to postoperative analgesia requirement with reduced 24-hour pain scores.\nWe recommend larger studies to explore this benefit. This trial is registered with Pan African Clinical Trial Registry number\nPACTR201404000807178.
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