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Comparison of caudal ropivacaine, ropivacaine plus ketamine and ropivacaine plus tramadol administration for postoperative analgesia in children
Author(s) -
Güneş Y.,
Seçen M.,
Özcengi̇z D.,
Gündüz M.,
Balcioǧlu O.,
Işik G.
Publication year - 2004
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2004.01220.x
Subject(s) - ropivacaine , medicine , tramadol , ketamine , anesthesia , analgesic
Summary Background : The aim of this study was to compare the effect of single‐dose caudal ropivacaine, ropivacaine plus ketamine and ropivacaine plus tramadol in children for postoperative pain management. Methods : Following ethics committee approval and informed parental consent, 99 ASA PS I or II children, between 1 and 10 years of age, scheduled for elective inguinal hernia repair with general anaesthesia, were recruited. After induction of anaesthesia and placement of a laryngeal mask airway (LMA TM ), the patients were randomly divided into three groups to receive either caudal ropivacaine alone (0.4%, 2 mg·kg −1 ) in group R ( n = 32) or ropivacaine (0.2%, 1 mg·kg −1 ) plus ketamine (0.25 mg·kg −1 ) in group RK ( n = 33) or ropivacaine (0.2%, 1 mg·kg −1 ) plus tramadol (1 mg·kg −1 ) in group RT ( n = 34) with a total volume of 0.5 ml·kg −1 . Systemic blood pressure (SBP and DBP), heart rate (HR), peripheral O 2 saturation (SpO 2 ), respiratory rate (RR), sedation and pain scores were recorded at 5, 10, 15 and 30 min, 1, 3, 4 and 6 h following recovery from anaesthesia. Pain was evaluated by Children's Hospital of Eastern Ontario Pain Scale, and sedation with a five‐point sedation test. Results : No difference was found regarding age, weight and duration of operation between the groups ( P > 0.05). No patient experienced hypotension, bradycardia or respiratory depression. Duration of analgesia was longer in group RT (1377 ± 204 min) than group R (1006 ± 506 min) ( P = 0.001). In the tramadol group, fewer patients required supplementary analgesics in the first 24 h ( P = 0.005). Sedation scores were below 2 in all groups. Incidence of postoperative nausea and vomiting was higher in group RT (eight patients) and group RK (seven patients) than group R (one patient, P = 0.032). Conclusions : Ropivacaine (0.4%), ropivacaine (0.2%) plus ketamine (0.25 mg·kg −1 ) and ropivacaine (0.2%) plus tramadol (0.5 mg·kg −1 ) provided sufficient analgesia in children, but the duration of analgesia was longer in the RT group.