The optimal dose of ketamine for caudal epidural blockade in children.
Sixty boys aged up to 9 years undergoing orchidopexy were randomly allocated to receive one of three solutions for caudal epidural injection: group A received 1 ml.kg-1 of 0.25% bupivacaine with 0.25 mg.kg-1 of preservative-free ketamine, group B received 1 ml.kg-1 of 0.25% bupivacaine with ketamine 0.5 mg.kg-1 and group C received 1 ml.kg-1 of 0.25% bupivacaine with 1 mg.kg-1 of ketamine. Postoperative pain was assessed by means of a modified Objective Pain Score and analgesia was administered if this score exceeded four. The median duration of caudal analgesia was 7.9 h in group A, 11 h in group B and 16.5 h in group C. There were no differences between the groups in the incidence of motor block, urinary retention, postoperative vomiting or postoperative sedation. Group C had a significantly higher incidence of behavioural side effects, including slightly odd behaviour, vacant stares and abnormal effect than groups A and B.
Semple
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Department of Anaesthesia, Royal Hospital for Sick Children, Edinburgh.
Findlow
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Aldridge
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Doyle
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D000763:Anesthesia, Caudal; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D000779:Anesthetics, Local; D002045:Bupivacaine; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010149:Postoperative Pain; D011184:Postoperative Period
D019162:Anesthetics, Combined; D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D007649:Ketamine; D002045:Bupivacaine