Ketamine for Caudal Analgesia in Children: Comparison With Caudal Bupivacaine

Naguib, Mohamed; Sharif, Atif; Seraj, Mohamed A.; Gammal, Mohamed El; Dawlatly, Abdel Azim El

doi:10.1093/bja/67.5.559

Cited by 155 publications

(105 citation statements)

References 14 publications

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“…16 Naguib et al compared bupivacaine 0.25% 1 ml/kg with or without ketamine 0.5 ml/kg and ketamine 0.5 mg /kg with normal saline 1 ml/kg. 17 There was no significant difference in the quality of pain between the ketamine and the other two groups. The bupivacaine with ketamine group provided better analgesia with lesser side effects than with bupivacaine alone.…”

Section: Resultsmentioning

confidence: 80%

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Singh

Shah

Vaidya

et al. 2013

Kathmandu Univ. Med. J.

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Background Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. Objectives To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single shot technique in children. Methods Eighty children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg (Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl 1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32 min) than other three groups P < 0.05. The pain score assessed using FLACC scale was compared between the four groups, and children in Group BC had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects in compare to fentanyl or ketamine. Conclusion We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75 ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25% bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone, without any side effects. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 25-29 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8013

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Section: Resultsmentioning

confidence: 80%

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Singh

Shah

Vaidya

et al. 2013

Kathmandu Univ. Med. J.

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“…2 The use of ketamine, clonidine and opioids is limited because of potential side effects such as nausea, vomiting, sedation and respiratory depression. [3][4][5][6][7][8] The role of neostigmine as an analgesic administered by the extradural route is now well established in children and adults. [9][10][11][12] Co-administration of caudal neostigmine in a dosage of 2 µg·kg -1 with bupivacaine or ropivacaine has been found to provide prolonged analgesia without any adverse effects.…”

Section: R Re Es Su Ul Lt Ts S:mentioning

confidence: 99%

Caudal neostigmine with bupivacaine produces a dose-independent analgesic effect in children

Mahajan

Grover

Chari

2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To evaluate the analgesic efficacy and duration of varying doses of caudal neostigmine with plain bupivacaine and its side effects in children undergoing genito-urinary surgery. M Me et th ho od ds s: :In a randomized double-blind prospective study 80 boys aged two to eight years scheduled for surgical repair of hypospadias were allocated randomly to one of four groups (n = 20 each) and received either only caudal 0.25% plain bupivacaine 0.5 mL·kg -1 (Group I) or 0.25% plain bupivacaine 0.5 mL·kg -1 with neostigmine (Groups II-IV) in doses of 2, 3 and 4 µg·kg -1 respectively. Postoperative pain was assessed for 24 hr using an objective pain score. Blood pressure, heart rate, oxygen saturation, total amount of analgesic consumed and adverse effects were also recorded.R Re es su ul lt ts s: : The duration of postoperative analgesia in Group I (5.1 ± 2.3 hr) was significantly shorter than in the other three groups (II -16.6 ± 4.9 hr; III -17.2 ± 5.5 hr; IV -17.0 ± 5.8 hr; P < 0.05). Total analgesic (paracetamol) consumption was significantly more in Group I (697.6 ± 240.7 mg) than in the groups receiving caudal neostigmine (II -248.0 ± 178.4; III -270.2 ± 180.8 and IV -230.6 ± 166.9 mg; P < 0.05). Groups II, III and IV were comparable with regards to duration of postoperative analgesia and total analgesic consumption (P > 0.05). Incidence of nausea and vomiting were comparable in all four groups. No significant alteration in vital signs or any other adverse effects were observed. C Co on nc cl lu us si io on ns s: : Caudal neostigmine (2, 3 and 4 µg·kg -1 ) with bupivacaine produces a dose-independent analgesic effect (. 16-17 hr) in children as compared to those receiving caudal bupivacaine alone (approximately five hours) and a reduction in postoperative rescue analgesic consumption without increasing the incidence of adverse effects. 6 ± 4,9 h ;2 ± 5,5 h ;0 ± 5,8 h ; P < 0,05). La consommation totale d'analgésique (paracétamol) a été significativement plus élevée dans le Groupe I (697,6 ± 240,7 mg) que dans les groupes avec néostigmine caudale 0 ± 178,4 ;2 ± 180,6 ± 166,9 mg ; P < 0,05 Objectif

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“…24 Naguib et al (1991) observed patients having nausea/ vomiting, urinary retention ,muscle weakness in post operative period after caudal bupivacaine and ketamine. 25 From the result of this study we conclude the clonidine when added to caudal bupivacaine provided superior quality and longer duration of analgesia requiring less doses of rescue analgesia in post operative period compared to bupivacaine with neostigmine at no additional risk.…”

mentioning

confidence: 62%

Caudal Neostigmine and Clonidine as Adjuncts to Bupivacaine for Post Operative Analgesia in Children Undergoing Sub Umbilical Surgery

Gani¹

2017

JMSCR

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Ketamine for Caudal Analgesia in Children: Comparison With Caudal Bupivacaine

Cited by 155 publications

References 14 publications

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Caudal neostigmine with bupivacaine produces a dose-independent analgesic effect in children

Caudal Neostigmine and Clonidine as Adjuncts to Bupivacaine for Post Operative Analgesia in Children Undergoing Sub Umbilical Surgery

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