CAUDAL ANALGESIA IN PAEDIATRICS: COMPARISON BETWEEN BUPIVACAINE ALONE AND IN COMBINATION WITH KETAMINE FOR POSTOPERATIVE ANALGESIA IN GVMC, VELLORE

BACKGROUND Caudal block is a common technique for paediatric analgesia, but with the disadvantage of short duration of action of bupivacaine after single injection. Caudal ketamine could offer significant analgesic benefits. We compared the analgesic effects and side effects of ketamine added to bupivacaine in paediatric patients undergoing lower abdominal surgeries. MATERIALS AND METHODS One hundred patients (1 yr. to 10 yrs.) were randomly assigned into two groups in a double -blinded manner. After halothane in oxygen general anaesthesia, 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, pain score, sedation score, use of analgesics and side effects were assessed during the first 24 h. RESULTS Addition of ketamine to caudal bupivacaine significantly prolonged the duration of analgesia than the use of bupivacaine alone. There is a statistically significant difference between bupivacaine alone and in combination with ketamine with regards to the analgesia time (p < 0.001). No significant difference was observed in incidence of haemodynamic changes or side-effects. CONCLUSION Addition of ketamine to caudal bupivacaine significantly prolonged analgesia in children undergoing lower abdominal surgeries.