How to prolong postoperative analgesia after caudal anaesthesia with ropivacaine in children: S-ketamine versus clonidine.
BACKGROUND
The aim of the study was to determine whether caudal S-ketamine or clonidine prolonged analgesia together with ropivacaine.


METHODS
Sixty-three boys, aged 1-5 years, who were undergoing minor surgery, were allocated in order to receive one of three solutions for caudal anaesthesia. Group R received 2 mg x kg(-1) 0.2% ropivacaine; group C, 2 mg x kg(-1) 0.2% ropivacaine + clonidine 2 microg x kg(-1); and group K, 2 mg x kg(-1) 0.2% ropivacaine + S-ketamine 0.5 mg x kg(-1).


RESULTS
Postoperative analgesia assessed by CHEOPS lasted 701 min in group K (P < 0.05) compared with 492 min in group C and 291 min in group R. There were no significant differences between the groups for incidence of haemodynamic and respiratory alterations, motor block or sedation.


CONCLUSIONS
This study demonstrates that S-ketamine 0.5 mg x kg(-1) when added to 0.2% caudal ropivacaine provides better postoperative analgesia than clonidine without any clinically significant side-effect.
De Negri
P
P
Department of Anaesthesia, IRCCS 'Casa Sollievo della Sofferenza', S. Giovanni Rotondo (FG), Turin, Italy. pdegegri@tin.it
Ivani
G
G
Visconti
C
C
De Vivo
P
P
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000577:Amides / Q000009:adverse effects; D015360:Analgesia, Epidural / Q000009:adverse effects; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative / Q000009:adverse effects / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000009:adverse effects / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D015656:Respiratory Mechanics / Q000187:drug effects; D000077212:Ropivacaine
D000316:Adrenergic alpha-Agonists; D000577:Amides; D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D007649:Ketamine; D000077212:Ropivacaine; D003000:Clonidine