Comparison of the effects of epidural and intravenous ketamine on the duration of epidural analgesia in children

Abstract

Abstract Nineteen children undergoing surgical correction of congenital talipes equinovarus were randomly allocated to receive one of two analgesic regimens. Group IV received 1 ml/kg −1 of bupivacaine 0.25% epidurally and ketamine 0.5 mg/kg −1 intravenously and Group C received 1 ml/kg −1 of bupivacaine 0.25% with ketamine 0.5 mg/kg −1 epidurally. Venous blood was taken at intervals after the administration of ketamine and assayed for ketamine. Postoperative pain was assessed by means of a modified Objective Pain Score and analgesia was administered if this score exceeded four. The median duration of caudal analgesia was 4.5 hours in Group IV compared with 6 hours in Group C (p max ) was not measured in Group IV and was 0.35 μg/ml −1 (range 0.17–0.96 μg/ml −1 ) in Group C. The median time taken to attain C max (T max ) was not measured in Group IV and was 45 minutes (range 5–50 minutes) in Group C. The terminal elimination half life was 11.3 hours in both groups. There were no differences between the groups in the time taken to recover from anaesthesia.