Comparison of pre-emptive analgesic effect of rectal ketamine and caudal bupivacaine in pediatric lower abdominal surgery

Amir Shafa, Seyedjalal Hashemi, Seyedmorteza Heidari, zeynab Talebi



Background: Ketamine is a medication that suppresses the central nervous system and can be used as an analgesic. The aim of this study isto compare the post-operative pain reduction of rectal ketamine and caudal bupivacaine in pediatric lower abdominal surgery.

Method: This was a double-blind clinical trial studywhich performed on 68 children aged 1-7 years that allocated into two groups of 34 patients. The first Group received rectal ketamine (2mg/kg), and the second received 0.75mg/kg caudal bupivacaine (0.125%). Mean pain intensity and hemodynamic variables were recorded 2,6,12 and 24 hours after lower abdominal surgery in children. Pain was assessed using FLACC (Face, Legs, Activity, Cry, Consolability) Scale.

Results: No significant difference was found in terms of pain intensity between admission and discharge from recovery (p>0.05). Patients who received ketamine endured less pain than bupivacaine 2, 6, and 12 hours following surgery (p<0.05). Mean extubation time and duration of recovery stay was significantly shorter in ketamine group. 

Conclusion: Rectal ketamine was associated with more effective pain control and shorter recovery stay, when compared to caudal bupivacaine in lower abdominal pediatric surgery.


Postoperative pain,Rectal Ketamine, Caudal Bupivacaine, Pain Management, Lower abdominal surgery

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