Abstract
BackgroundCaudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. However, the effect of caudal ketamine on the minimum local anesthetic concentration (MLAC) of ropivacaine for intra-operative analgesia is unclear.MethodsOne hundred and sixty-nine children were randomized to five groups: Group C (caudal ropivacaine only), Group K0.25 (caudal ropivacaine plus 0.25 mg/kg ketamine), Group K0.5 (caudal ropivacaine plus 0.5 mg/kg ketamine), Group K0.75 (caudal ropivacaine plus 0.75 mg/kg ketamine), and Group K1.0 (caudal ropivacaine plus 1.0 mg/kg ketamine). The primary outcome was the MLAC values of ropivacaine with/without ketamine for caudal block.ResultsThe MLAC values of ropivacaine were 0.128% (0.028%) in the control group, 0.112% (0.021%) in Group K0.25, 0.112% (0.018%) in Group K0.5, 0.110% (0.019%) in Group K0.75, and 0.110% (0.020%) in Group K1.0. There were no significant differences among the five groups for the MLAC values (p = 0.11). During the post-operative period the mean durations of analgesia were 270, 381, 430, 494, and 591 min in the control, K0.25, K0. 5, K0.75, and K1.0 groups respectively, which shown that control group is significantly different from all ketamine groups. Also there were significant differences between K0.25 and K0.75 groups, and between K1.0 groups and the other ketamine groups.ConclusionsAdding caudal ketamine to ropivacaine prolong the duration of post-operative analgesia; however, it does not decrease the MLAC of caudal ropivacaine for intra-operative analgesia in children.Clinical trial registrationChiCTR-TRC-13003492. Registered on 13 August 2013.
Highlights
Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects
Many additives have been administrated in order to decrease the concentration of local anesthetics for caudal analgesia, while the effect of some additives on the minimum local anesthetic concentration (MLAC) values of local anesthetics have been explored in some previous studies [8, 9]
Our results showed that combined ketamine with ropivacaine for caudal block would prolong the duration of post-operative analgesia
Summary
Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. The effect of caudal ketamine on the minimum local anesthetic concentration (MLAC) of ropivacaine for intra-operative analgesia is unclear. Single dose caudal levobupivacaine or ropivacaine provides analgesia for 4–8 h and has gained popularity with a high success rate and a low incidence of adverse effects [1, 2]. Many additives have been administrated in order to decrease the concentration of local anesthetics for caudal analgesia, while the effect of some additives on the MLAC values of local anesthetics have been explored in some previous studies [8, 9]. As a commonly used additive, caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse events. The aim of this prospective, randomized, and double-blind trial was to observe whether ketamine reduces the MLAC of ropivacaine for caudal block in children
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
