Caudal analgesia in children: S(+)-ketamine vs S(+)-ketamine plus clonidine.
BACKGROUND
The aim of this study was to evaluate postoperative analgesia provided by caudal S(+)-ketamine and S(+)-ketamine plus clonidine without local anesthetic.


METHODS
Forty-four children aged 1-5 years consecutively scheduled for inguinal hernia repair, hydrocele repair or orchidopexy were randomly assigned to receive a caudal injection of either S(+)-ketamine 1 mg x kg(-1) (group K) or S(+)-ketamine 0.5 mg x kg(-1) plus clonidine 1 microg x kg(-1) (group KC). Postoperative analgesia and sedation were evaluated by CHEOPS and Ramsay scale from emergence from general anesthesia for 24 h.


RESULTS
No statistical difference was observed between study groups with respect to pain and sedation assessment. A slight trend toward a reduced requirement for rescue analgesia in group KC was observed, although not statistically significant.


CONCLUSIONS
Caudal S(+)-ketamine 1 mg x kg(-1) and S(+)-ketamine 0.5 mg x kg(-1) plus clonidine 1 microg x kg(-1) are safe and provide effective postoperative analgesia in children without adverse effects.
Passariello
M
M
Department of Anaesthesia and Intensive Care Medicine, Univerity of Rome La Sapienza, Rome, Italy. maurizio.passariello@libero.it
Almenrader
N
N
Canneti
A
A
Rubeo
L
L
Haiberger
R
R
Pietropaoli
P
P
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000698:Analgesia / Q000009:adverse effects; D000762:Anesthesia Recovery Period; D000763:Anesthesia, Caudal / Q000009:adverse effects; D000778:Anesthetics, Dissociative / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D016343:Monitoring, Intraoperative; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D013237:Stereoisomerism; D006848:Testicular Hydrocele / Q000601:surgery
D000316:Adrenergic alpha-Agonists; D000778:Anesthetics, Dissociative; D007649:Ketamine; D003000:Clonidine