Mohammad Reza Razavizadeh - Dept. of Anesthesiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Mehdi Rajabi - Dept. of Anesthesiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Alireza Moraveji - Dept. of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran
Ehsan Shafiei Rad - Dept. of Anesthesiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Mehrdad Mahdian - Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran

 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 ۲۳۱ subjects, all of whom were candidates for a CS during ۲۰۱۶. The patients were evaluated based on the type of medication received. After undergoing spinal anesthesia, the first group received ۰.۵ mg/kg ketamine intravenously and the second group received ۰.۱ 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 ۱ h, ۶ h, ۱۲ h, ۱۸ h, and ۲۴ 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<۰.۰۵). In addition, the number of pethidine recipients in the control group was significantly higher (P<۰.۰۰۱).  Conclusion:  The results showed that prophylactic administration of dexamethasone and ketamine is effective in relieving shoulder pain after a CS.

Caesarean section, Spinal anesthesia, Shoulder pain, Dexamethasone, Ketamine