Abstract

Aim: To compare the analgesic effectiveness of ketamine or bupivacaine infiltration of the incision Phannenstiel for postoperative analgesia in patients carried to a cesarean section at the Hospital Central Dr. Urquinaona in Maracaibo, Venezuela. M ethods: comparative research, with a quasi-experimental design, was carried out, including 70 pregnant women scheduled for elective segmentalcesarean section under epidural anesthesia with bupivacaine plus fentanyl, randomly divided to receive incisional infiltration with ketamine (Group A) or bupivacaine (Group B). Results: Incisional infiltration with Ketamine decreased postoperative pain intensity, with mild pain in these patients, while pain in the Bupivacaine group was mild to moderate (p = 0.002). The pain-free time was significantly greater when using Ketamine (2.86 ± 0.81 vs. 1.57 ± 0.78 hours, p = 0.0001), while the rescue with intravenous analgesics was higher in the group where Bupivacaine was used than in those that were administered Ketamine (17 % vs. 51.4 %, p = 0.003). The use of ketamine was associated with a greater occurrence of chills and extreme sedation (p <0.001), as well as postoperative nausea and vomiting (p <0.05). Conclusions: Incisional infiltration with Ketamine was more effective than with Bupivacaine, decreasing pain intensity and analgesic consumption in the postoperative period of the segmental cesarean section.