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Effects of ketamine added to ropivacaine in pediatric caudal block

Ramazan Odeş1, Omer Lütfi Erhan, Muhammed Demirci

  • 1Department of Anesthesiology and Reanimation Firat University Faculty of Medicine, Elaziğ, Turkey.

Agri : Agri (Algoloji) Dernegi'Nin Yayin Organidir = the Journal of the Turkish Society of Algology
|June 29, 2010
PubMed

Insights

Adding ketamine to ropivacaine via caudal anesthesia significantly improved postoperative pain control and extended analgesia duration in pediatric inguinal hernia repair. This combination reduced the need for additional pain medication.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Procedures

Background:

  • Pediatric inguinal hernia repair commonly requires effective postoperative pain management.
  • Caudal anesthesia is a frequent technique for pain control in pediatric surgery.
  • Optimizing analgesic strategies is crucial for patient recovery and comfort.

Purpose of the Study:

  • To evaluate the hemodynamic effects and postoperative pain control of caudal ropivacaine versus ketamine combined with ropivacaine in children undergoing inguinal hernia repair.
  • To compare the quality and duration of analgesia provided by different caudal anesthetic combinations.

Main Methods:

  • A randomized study involving 45 pediatric patients (1-4 years) undergoing inguinal hernia repair.
  • Patients received caudal anesthesia with either ropivacaine (Group R), ketamine (Group K), or ropivacaine plus ketamine (Group R+K).
  • Postoperative pain was assessed using the modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), and sedation was evaluated using the Wilson Sedation Scale.

Main Results:

  • Ropivacaine plus ketamine (Group R+K) demonstrated significantly lower postoperative pain scores at 45 and 60 minutes compared to ropivacaine alone (Group R).
  • The effective analgesic period was significantly longer in the ketamine (Group K) and ropivacaine plus ketamine (Group R+K) groups compared to the ropivacaine-only group.
  • The ropivacaine plus ketamine group required lower doses of postoperative analgesics within the first 24 hours, with no significant differences in adverse events or sedation levels across groups.

Conclusions:

  • Caudal administration of ropivacaine, ketamine, or a combination thereof provides effective postoperative analgesia in pediatric patients.
  • Combining ketamine with ropivacaine significantly enhances the duration of analgesia and reduces the need for supplementary pain medication after inguinal hernia repair.
  • The combination of caudal ropivacaine and ketamine offers a superior approach to postoperative pain management in this pediatric surgical population.
Abstract

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