Caudal bupivacaine and s(+)-ketamine for postoperative analgesia in children.
BACKGROUND
The aim of this study was to evaluate whether caudal s-ketamine would prolong analgesia together with caudal bupivacaine.


METHODS
Thirty children, ASA I-II, 1 month-9 years, scheduled for minor inguinal or penile surgery, were randomly assigned in a prospective, double-blind fashion to receive single shot caudal blockade by either bupivacaine 0.125% 1 ml.kg(-1) (group B, n = 15) or a mixture of bupivacaine 0.125% 1 ml.kg(-1) and preservative-free s-ketamine 0.5 mg.kg(-1) (group K, n = 15). Postoperative pain was assessed by means of an observational 10-point scoring system and analgesia was administered if the pain score exceeded a value of 3.


RESULTS
Within 24 h after caudal block 10 patients (67%) in group K and three patients in group B (20%) did not require additional analgesic medication (P < 0.01). There were no significant differences between the groups for incidence of haemodynamic changes. We did not observe any negative side-effects attributable to the caudal block or s-ketamine.


CONCLUSIONS
Addition of preservative-free s-ketamine 0.5 mg.kg(-1) to caudal bupivacaine 0.125% 1 ml.kg(-1) provides significant prolongation of analgesia without producing negative side-effects.
Weber
Frank
F
Department of Anaesthesia, University of Regensburg, Regensburg, Germany. frank.weber@klinik.uni-regensburg.de
Wulf
Hinnerk
H
D000700:Analgesics / Q000627:therapeutic use*; D000763:Anesthesia, Caudal; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013514:Surgical Procedures, Operative; D013997:Time Factors
D000700:Analgesics; D000779:Anesthetics, Local; D007649:Ketamine; D002045:Bupivacaine