Anesthesia & Clinical Research
Open Access

Abstract

Efficacy of Caudal Ketamine with Different Concentrations of Levobupivacaine for Postoperative Analgesia in Paediatric Subumblical Surgeries

Mona Mohamed Mogahed and Eman Ramadan Salama

Background: Caudal anaesthesia is the most popular regional anaesthetic technique used in the paediatric age group. Ketamine has been shown to have a synergistic effect with caudal local anaesthetics. Levobupivacaine is generally a well-tolerated anesthetic and analgesic with a wide range of clinical effectiveness and can be used as an alternative to bupivacaine.

Methods: After approval from the hospital ethics committee and obtaining a parental informed written consent, fifty children with ASA score I and age ranges from 2-6 years randomized into 2 groups. Group I (n=25) received 0.75 ml/kg levobupivacaine 0.175% and preservative free s(+)-ketamine 0.5 mg/kg. Group II (n=25) received 0.75 ml/kg levobupivacaine 0.25% and preservative free s(+)-ketamine 0.5 mg/kg. Postoperative pain, duration of analgesia and time to first spontaneous leg movement between the two groups were compared.

Results: There were no statistically significant differences between the two groups as regarding the mean duration of analgesia and pain score assessed by using the FLACC scale; P value of >0.05. Mean duration of motor block determined by the mean time to first spontaneous leg movement was significantly longer in group II when Compared to group I; P value of 0.000.

Conclusion: The addition of ketamine decreased the required concentration of caudal levobupivacaine with a comparable duration of postoperative analgesia and significantly less residual motor blockade as compared to higher concentration.