Dear Lactnet Friends:

While I have no frame of reference to evaluate the medical aspects of using
this drug for anesthesia during cesarean section, I do enjoy that
breastfeeding was one of many variables  evaluated out to 3 years post
birth. I hope this is the birth of a new trend.

<
http://www.minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2012N07A0774
>

Minerva Anestesiol. <http://www.ncbi.nlm.nih.gov/pubmed/22374377#> 2012
Jul;78(7):774-81. Epub 2012 Feb 29.
A study of low-dose S-ketamine infusion as "preventive" pain treatment for
cesarean section with spinal anesthesia: benefits and side effects.
Suppa E<http://www.ncbi.nlm.nih.gov/pubmed?term=Suppa%20E%5BAuthor%5D&cauthor=true&cauthor_uid=22374377>
, Valente A<http://www.ncbi.nlm.nih.gov/pubmed?term=Valente%20A%5BAuthor%5D&cauthor=true&cauthor_uid=22374377>
, Catarci S<http://www.ncbi.nlm.nih.gov/pubmed?term=Catarci%20S%5BAuthor%5D&cauthor=true&cauthor_uid=22374377>
, Zanfini BA<http://www.ncbi.nlm.nih.gov/pubmed?term=Zanfini%20BA%5BAuthor%5D&cauthor=true&cauthor_uid=22374377>
, Draisci G<http://www.ncbi.nlm.nih.gov/pubmed?term=Draisci%20G%5BAuthor%5D&cauthor=true&cauthor_uid=22374377>
.
 Source

Department of Anesthesiology and Resuscitation Medicine, Sacro Cuore
Catholic University, Rome, Italy.
 Abstract BACKGROUND:

Attenuation of central sensitization with NMDA-active drugs such as
S-Ketamine may play a role in postoperative analgesia and prevention of
neuropathic pain. However, during cesarean section with neuraxial block,
S-Ketamine might have adverse effects on the interaction between mothers
and infants, including breastfeeding.
METHODS:

Women undergoing elective repeat cesarean section with subarachnoid
anesthesia (0.5% hyperbaric bupivacaine 8-10 mg and sufentanil 5 μg) were
enrolled in a double-blind, randomized study. Patients in the S-Ketamine
group (N.=28) received i.v. midazolam 0.02 mg/kg and S-Ketamine 0.5 mg/kg
i.m. bolus 10 minutes after birth followed by a 2 μg/kg/min i.v. continuous
infusion for 12 h. The control group (N.=28) received placebo. Paracetamol
and patient controlled analgesia with intravenous morphine were given
postoperatively. Von Frey filaments were used to assess pain threshold on
the inner forearm and T10-T11 dermatomes (supposed hyperalgesic area).
RESULTS:

S-Ketamine reduced morphine consumption at 4-8, 8-12, and 12-24 hours after
surgery (total 31%), even after its effect has ceased, suggesting an
anti-hyperalgesic action. Mild side effects were observed in the S-Ketamine
group one hour after delivery. All side effects were rated as light and
there were no serious adverse events. Pain threshold was not significantly
different between groups. S-Ketamine patients showed a trend towards
reduced pain sensitivity at the T10 dermatome, which is involved by
surgical damage. After three years, patients reported no differences in
residual pain, dysesthetic symptoms, or duration of breast-feeding.



warmly,

-- 
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com
https://www.facebook.com/nikkileehealth

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