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



Introduction: Ketamine is a medication that suppresses the central nervous system and can be used as an analgesic. The aim of this study is to compare the post-operative pain reduction of rectal ketamine and caudal bupivacaine in pediatric lower abdominal surgery.
Materials and Methods: This double-blind clinical trial was performed on 68 children aged 1-7 years whom were 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 following lower abdominal surgery in children. Pain was assessed using FLACC (Face, Legs, Activity, Cry, Consolability) Scale.
Results: There were no significant difference 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 the 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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