Comparison of pre-emptive analgesic effect of rectal ketamine and caudal bupivacaine in pediatric lower abdominal surgery
Iranian Journal of Pediatric Surgery,
Vol. 4 No. 2 (2018),
4 Azar 2018
,
Page 61-70
https://doi.org/10.22037/irjps.v4i2.22280
Abstract
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
How to Cite
References
Burton MJ, GlasziouPP: Tonsillectomy or adenotonsillectomyadenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 2009; 21(1):CD001802.
Umuroglu T, Eti Z, Ciffci H, et al: Analgesia for adenotonsillectomy in children: A comparison of morphine, ketamine and tramadol. PaediatrAnaesth 2004;14(7):568-73.
Hosseini Jahromi SA, Sadeghi Poor S, Hosseini Valami SM, et al: Effects of suppository acetaminophen, bupivacaine wound infiltration and caudal block with bupivacaine on postoperative pain in pediatric inguinal herniorrhaphy. Anesth Pain Med. 2012;1(4):243-7. doi: 10.5812/aapm.3551. Epub 2012 Apr 1.Miller’s Anesthesia , Eriksson LI: Elsevier Health Sciences; 2009:566-9.
Tanaka M , Sato M, Saito A, et al: Reevaluation of rectal ketamine premedication in children: comparison with rectal midazolam. Anesthesiology 2000;93(5):1217-24.
Somdas MA, Senturk M, Ketenci I, et al: Efficacy of bupivacaine for post-tonsillectomy pain: a study with the intra-individuldesing. J Pediatr Otorhinolaryngol 2004;68(11):1391-1395.
Sorensen WT, Wagner N, Aarup AT Bonding P: Beneficial effect of low-dose peritonsillar injection of lidocaine- adrenaline before tonsillectomy. A placebo-controlled clinical trial, Auris Nasus Larynx 2003;30(2):159-162.
Engindeniz Z, Demircab C, Karli N, et al: Intramuscular tramadol vs.diclofenac sodium for the treatment of acute migraineattacks in emergency department: a perspective randomized double blind
study. Headache Pain 2005;6(3):143-148.
Ozcan S, Yilmaz E, Buyukkocak U, et al: Comparison of three analgesics for extracorporeal shockwave lithotripsy. J Urol Nephrol 2002;36(4):281-285.
Jain A, Muralidhar V, Aneja S, et al: A prospective observational study comparing criteriabased discharge method with traditional time-based discharge method for discharging patients frompost-anaesthesia care unit undergoing ambulatory or outpatient minor surgeries under general
anaesthesia. Indian J Anaesth 2018;62(1):61-65.
Dwivedi R, Cipolle C, Hoefer C: Development and Assessment of an Interprofessional Curriculum for Managing Diabetes during Ramadan. Am J Pharm Educ 2018;82(7):6550.
Moshiri, E, Noruzi,A, SH, Gazerani N, et al: The effect of low dose ketamine on postoperative pain after spinal anesthesia in elective cesarean section. Arak Medical University Journal (AMUJ) 2011; 14(55): 81-88.
SayinVoepel-Lewis T, Merkel S, TaitAR: Cry Consolability observational tool as a measure of pain in children with cognitive impairment. Anesth Analg 2002;95(5): 1224-9.
Sayin MM, Mercan A, Ture H, et al: The effect of 2 different concentrations of rectal ketamine on its premedicant features in children. Saudi Med J 2008;29(5):683-7.
Tyler DC, Krane EJ, Hester NO, et al: Measurement of pain in children: Generalizability and validity of the pain ladder and the poker chip tool. Pediatric pain 1990;15:79-93.
Arbabi S, Shirmohammadi M, Ebrahimsoltani A, et al: The effect of caudal anesthesia with bupivacaine and its mixture with midazolam or ketamine on postoperative pain control in children JAP 2013;3(4):210-215.
Mirlohi SZ, Hashemi SJ. Heidari SM: Comparison of the preventive analgesic effect of rectal ketamine and rectal acetaminophen after pediatric tonsillectom. Int J Prev Med 2012;3(Suppl1):S150-5.
- Abstract Viewed: 399 times
- PDF Downloaded: 294 times