Comparison of the effects of adrenaline, clonidine and ketamine on the duration of caudal analgesia produced by bupivacaine in children.
Sixty boys, aged 1-10 yr, undergoing orchidopexy were allocated randomly to receive one of three solutions for caudal extradural injection. Group A received 0.25% bupivacaine 1 ml kg-1 with adrenaline 5 micrograms ml-1 (1/200,000), group C received 0.25% bupivacaine 1 ml kg-1 with clonidine 2 micrograms kg-1 and group K received 0.25% bupivacaine 1 ml kg-1 with ketamine 0.5 mg kg-1. Postoperative pain was assessed using a modified objective pain score and analgesia was administered if this score exceeded 4. The median duration of caudal analgesia was 12.5 h in group K compared with 5.8 h in group C (P < 0.05) and 3.2 h in group A (P < 0.01). There were no differences between the groups in the incidence of motor block, urinary retention or postoperative sedation.
Cook
B
B
Department of Anaesthetics, Royal Hospital for Sick Children, Edinburgh.
Grubb
D J
DJ
Aldridge
L A
LA
Doyle
E
E
D000698:Analgesia / Q000379:methods*; D000778:Anesthetics, Dissociative / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003000:Clonidine / Q000627:therapeutic use*; D003456:Cryptorchidism / Q000601:surgery; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011184:Postoperative Period; D013565:Sympatholytics / Q000627:therapeutic use; D013566:Sympathomimetics / Q000627:therapeutic use
D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D013565:Sympatholytics; D013566:Sympathomimetics; D007649:Ketamine; D003000:Clonidine; D002045:Bupivacaine; D004837:Epinephrine