Umbrin Naz, Muhammad Ilyas, Ambareen Sifatullah, Sayed Shah Hassanain, Robina Bangash, Zaid Javaid, Parhaizgar Khan.
Caudal block using Ketamine with Bupivacaine and Bupivacaine alone for post-operative analgesia in Paediatric inguino-scrotal surgeries.
Pak J Surg Jan ;36(1):90-5.

Background: Caudal block is a common technique for pediatric analgesia, but with the disadvantage of the short duration of action of bupivacaine after a single injection. Caudal ketamine could offer significant analgesic benefits. We compared the analgesic effects and side effects of ketamine added to bupivacaine in pediatric patients under-going inguino-scrotal surgeries. Materials and Methods: 80-patients (3 to 10 years) were randomly assigned into 2-groups by lottery method. Aft er sevoflurane in oxygen general anaesthesia induction, each patient received either a single caudal dose of bupivacaine 0.25% (1 mL/kg) with normal saline or bupivacaine 0.25% with ketamine 0.5 mg/kg. Haemodynamic variables, MOPS score, analgesia duration, use of analgesics and side effects were assessed during the first 12 h. Results: Addition of ketamine to caudal bupivacaine significantly prolonged the duration of analgesia than the use of bupivacaine alone. Th ere was a statistically significant difference between bupivacaine alone and in combination with ketamine with regards to the analgesia time (p < 0.05). No significant difference was observed in incidence of side-effects. Conclusion: Addition of ketamine to caudal bupivacaine significantly prolonged analgesia in children undergoing inguinoscrotal surgeries.

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