title: Comparison between caudal bupivacaine and bupivacaine with ketamine for postoperative analgesia in children: A prospective randomized clinical study.
abstract: BACKGROUND
  Efficacy of caudal bupivacaine plus ketamine on postoperative pain in children.
  
  
  OBJECTIVE
  The aim of this study was to compare the analgesic efficacy and safety of caudal block with mixture of bupivacaine and ketamine to bupivacaine alone for postoperative analgesia in pediatric patients undergoing infraumbilical surgery.
  
  
  METHODS
  A prospective randomized study was conducted in a tertiary care teaching hospital.
  
  
  METHODS
  Data were collected; mean value and standard deviation were computed for age, weight, duration of surgery, and duration of analgesia. Then, the mean values of the two groups were compared using ANOVA.P< 0.05 was considered statistically significant.
  
  
  METHODS
  A total of 60 American Society of Anesthesiologists I and II pediatric patients of either sex, aged 1-10 years, undergoing herniotomy, orchidopexy, and urethroplasty were randomly allocated to receive one of the two analgesic regimens. Group A (30 patients) received caudal bupivacaine 0.25% in a dose of 1 ml/kg, and Group B received caudal block with 0.25% bupivacaine 1 ml/kg and preservative-free ketamine 0.5 mg/kg; duration of analgesia was recorded by objective pain scale to equate pain and discomfort in young children with changes in standardized behavioral and physiological parameters.
  
  
  RESULTS
  Mean duration of analgesia in Group A was 5.63 ± 0.98 h while the mean duration of analgesia in Group B was 10.18 ± 2.24 h withP< 0.001. There were no differences between groups in the incidence of motor block and side effects.
  
  
  CONCLUSIONS
  On the basis of results derived from this study, it is concluded that addition of ketamine 0.5 mg/kg to caudal bupivacaine 0.25% in a dose of 1 ml/kg significantly prolonged the postoperative analgesia compared with administration of caudal bupivacaine 0.25% in a dose of 1 ml/kg alone.
authors.affiliation: Department of Anesthesiology, SHKM, GMC, Nalhar, Haryana, India.
authors.forename: Depinder
authors.initials: D
authors.lastname: Kaur
authors.affiliation: Institution of Critiical Care and Anesthsiology, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Anand
keywords: Bupivacaine; caudal epidural; ketamine; objective pain scale