The efficacy of preemptive ketamine and ropivacaine in pediatric patients: a placebo controlled, double-blind.
OBJECTIVE
We have evaluated and compared the preemptive efficacy of intravenous ketamine with placebo and caudal ropivacaine in pediatric patients going under elective hernia repair.


METHODS
60 ASAI-II pediatric patients ages between 1-12. The patients were divided into 3 groups randomly. Group K patients had 0.5mg/kg ketamine by intravenous route before induction,Group R patients had 0.7 mg/kg 0.2% ropivacaine caudally and 2ml normal saline intravenously,Group RK patients had 0.7 mg/kg 0.2% ropivacaine caudally and 0.5mg/kg ketamine by intravenous routeAll patients had standard anesthesia technique. Heart rate (HR), pulse oximetry, and systolic and diastolic blood pressure (BP), and BIS (bispectral index) were obtained during anesthesia, In addition, end-tidal carbon dioxide concentration was monitored. The efficacy of postoperative analgesia was documented by objective pain scale (OPS). Analgesic requirements during and after the surgery documented


RESULTS
While there was no significant differences in fentanyl consumption between the groups GR and GRK, fentanyl consumption was found to be significantly higher in group K during anesthesia.When compared with GR and GRK, GK had significantly higher OPS values. During postoperative period Group K patients demanded for additional analgesics in significantly shorter time than group R and Group K patients. GK patients had consumed significantly higher amounts of acetaminophen after surgery


CONCLUSIONS
Caudal application of ropivacaine in appropriate doses provides satisfactory peroperative and postoperative analgesia with no side effects in pediatric patient group going under elective hernia repair where as ketamine with the applied doses has no preemptive effect.
Köknel Talu
Gül
G
Department Of Algology, Medical Faculty Of Istanbul University, Capa 34390 Istanbul, Turkey. gktalu@yahoo.com
Ozyalçin
N Süleyman
NS
Balsak
Rukiye
R
Karadeniz
Meltem
M
D000577:Amides / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects; D059685:Herniorrhaphy; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000627:therapeutic use*; D009020:Morphine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D010919:Placebos; D000077212:Ropivacaine
D000577:Amides; D000701:Analgesics, Opioid; D010919:Placebos; D007649:Ketamine; D009020:Morphine; D000077212:Ropivacaine