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Analgesic effects of caudal and intramuscular S(+)-ketamine in children

H Koinig1, P Marhofer, C G Krenn

  • 1Departments of Anesthesiology and Intensive Care and Pharmacology, University of Vienna, Vienna, Austria. Herbert.Koinig@unvie.ac.at

Anesthesiology
|October 6, 2000
PubMed

Insights

Caudal S(+)-ketamine offers superior pain relief in children compared to intramuscular administration, suggesting a local analgesic effect. This method provides longer-lasting analgesia with lower plasma concentrations.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Previous research indicates caudal ketamine provides effective analgesia.
  • Understanding the route of administration is crucial for distinguishing local vs. systemic effects.

Purpose of the Study:

  • To compare the clinical effectiveness and plasma concentrations of S(+)-ketamine administered via caudal versus intramuscular routes in pediatric patients.
  • To elucidate whether caudal ketamine provides local or systemic analgesia.

Main Methods:

  • 42 pediatric patients (1-7 years) undergoing inguinal hernia repair received either caudal or intramuscular S(+)-ketamine (1 mg/kg).
  • Intraoperative monitoring included heart rate, mean arterial pressure, and oxygen saturation.
  • Postoperative assessments covered analgesia duration, sedation, hemodynamics, respiratory status, and plasma ketamine concentrations for 180 minutes.

Main Results:

  • Caudal S(+)-ketamine resulted in significantly longer analgesia duration (528 min) compared to intramuscular administration (108 min).
  • Plasma ketamine concentrations were significantly lower from 10 to 45 minutes post-caudal administration versus intramuscular.

Conclusions:

  • Caudal S(+)-ketamine provides effective intraoperative and postoperative analgesia in children.
  • The superior analgesia from caudal administration, despite similar plasma levels, indicates a local analgesic effect.
Abstract

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