title: Comparison of caudal ketamine with or without bupivacaine in pediatric subumbilical surgery.
abstract: In this prospective, randomized, double-blind study, we evaluated the perioperative analgesic efficacy of caudal ketamine with or without bupivacaine in 62 American Society of Anesthesiologists I-II children undergoing lower abdominal surgery. Patients were randomized into three groups, and all blocks were placed under general anesthesia. Group 1 (n=20) had caudal injection of plain 0.125% bupivacaine 1 mlkg(-1). Group 2 (n=22) received caudal ketamine 0.5 mgkg(-1) diluted with 0.9% saline using the same weight-related volumes. Group 3 (n=20) received a similar dose of ketamine mixed with 0.125% bupivacaine 1 mlkg(-1). No supplementary intraoperative analgesic was required in any of the groups. Patients in group 3 had the longest duration of analgesia compared to the other two groups. There was no significant difference in the incidence of side effects among the three groups. We conclude that ketamine can safely be used as an adjuvant to prolong the duration of caudal analgesia in this group of West African children.
authors.affiliation: Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109-0048, USA. onafiu@med.umich.edu
authors.forename: Olubukola O
authors.initials: OO
authors.lastname: Nafiu
authors.forename: Israel K
authors.initials: IK
authors.lastname: Kolawole
authors.forename: Richard A
authors.initials: RA
authors.lastname: Salam
authors.forename: Eniola O
authors.initials: EO
authors.lastname: Elegbe
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000763:Anesthesia, Caudal; D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D005260:Female; D005869:Ghana; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage* / Q000627:therapeutic use; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D020250:Postoperative Nausea and Vomiting; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D016194:Receptors, N-Methyl-D-Aspartate; D007649:Ketamine; D002045:Bupivacaine