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Ketamine for caudal analgesia in children: comparison with caudal bupivacaine
M Naguib1, A M Sharif, M Seraj
1Department of Critical Care Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain.
Insights
This study compared caudal anesthesia for pediatric inguinal herniotomy. Bupivacaine-ketamine mixture offered superior pain relief compared to bupivacaine alone, with no increased side effects.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Procedures
Background:
- Inguinal herniotomy is a common pediatric surgical procedure.
- Effective postoperative pain management is crucial for pediatric recovery.
- Caudal anesthesia is frequently used for pain control in pediatric surgeries.
Purpose of the Study:
- To evaluate the efficacy and safety of caudal ketamine combined with bupivacaine for pediatric inguinal herniotomy.
- To compare the analgesic effects of bupivacaine-ketamine mixture, bupivacaine alone, and ketamine with saline.
Main Methods:
- Randomized controlled trial involving 50 children undergoing inguinal herniotomy.
- Three groups received caudal injections: bupivacaine-ketamine, bupivacaine alone, or ketamine-saline.
- Pain relief, postoperative behavior, and analgesic requirements were assessed.
Main Results:
- The bupivacaine-ketamine mixture demonstrated superior analgesia compared to bupivacaine alone.
- No significant differences in pain relief, behavior, or analgesic needs were found between the ketamine group and the other groups.
- No motor weakness or urinary retention was observed in the ketamine group.
Conclusions:
- Caudal ketamine-bupivacaine provides enhanced analgesia for pediatric inguinal herniotomy.
- Ketamine, when used in caudal anesthesia for this procedure, appears safe with no significant adverse effects.
- Further research may explore optimal ketamine dosages and combinations for pediatric pain management.
Abstract:
Fifty children undergoing inguinal herniotomy were allocated randomly to three groups to receive a caudal injection of either 0.25% bupivacaine 1 ml kg-1 with or without ketamine 0.5 mg kg-1 or ketamine 0.5 mg kg-1 with normal saline 1 ml kg-1. There was no significant difference in quality of pain relief, postoperative behaviour or analgesic requirements between the ketamine group and the two other groups. The bupivacaine-ketamine mixture provided better analgesia than the bupivacaine solution alone. Side effects such as motor weakness or urinary retention were not observed in the ketamine group.