Effects of Ketamine and Clonidine for Caudal Analgesia Produced by Bupivacaine in Pediatric Ambulatory Surgery. |
Yu Mee Lee, Jeong Gill Leem, Hee Weon Ahn, Hong Seuk Yang, Dong Myung Lee, Sung Lyang Chung |
Department of Anesthesiology, University of Ulsan, Asan Medical Center, Seoul, Korea. |
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Abstract |
BACKGROUND Caudal block has proved to be a satisfactory method of providing perioperative analgesia for pediatric surgery in inguinal and perineal areas. This study was designed to evaluate the effects of ketamine or clonidine as an adjunctive of caudal block produced by bupivacaine. METHODS One hundred ninety five children aged 1~10 years, undergoing surgery in inguinal and perineal areas as ambulatory cases, were randomly allocated to one of four groups after the induction of general anesthesia; 0.25 % bupivacaine 1 ml/kg(group B), 0.25 % bupivacaine 1 ml/kg with ketamine 0.5 mg/kg(group K), 0.25 % bupivacaine 1 ml/kg with clonidine 1 microgram/kg(group C), and local infiltration group(group L). Postoperative pain was assessed using an objective pain scale and the incidence of side effects, such as urinary retention and nausea/vomiting was observed after surgery. RESULTS In the group B and L, OPS score was higher and analgesics were more frequently administered than group K and C at the recovery room and at home after discharge(p<0.05). There was no difference between the groups in the incidence of nausea and vomiting but urinary retention at the recovery room was more frequent in group C than other groups(p<0.05). CONCLUSIONS Caudal block provided more effective postoperative analgesia than local infiltration. In caudal block, the addition of ketamine or clonidine prolongs the duration of postoperative analgesia without significant increase in side effects. |
Key Words:
Analgesia: caudal; Analgesics: ketamine; clonidine; Anesthetics, local: bupivacaine; Pain: postoperative |
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