Comparison of the effect of ketamine added to bupivacaine and ropivacaine, on stress hormone levels and the duration of caudal analgesia

Akbas M., Titiz T., Ertugrul F., Akbas H., Melikoglu M.

ACTA ANAESTHESIOLOGICA SCANDINAVICA, cilt.49, sa.10, ss.1520-1526, 2005 (SCI-Expanded)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 49 Sayı: 10
  • Basım Tarihi: 2005
  • Doi Numarası: 10.1111/j.1399-6576.2005.00806.x
  • Dergi Adı: ACTA ANAESTHESIOLOGICA SCANDINAVICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1520-1526
  • Anahtar Kelimeler: caudal analgesia, bupivacaine, ropivacaine, ketamine, stress hormones, glucose, POSTOPERATIVE PAIN, EPIDURAL-ANESTHESIA, PEDIATRIC-PATIENTS, GROWTH-HORMONE, CHILDREN, BLOCK, SURGERY, CLONIDINE, CORTISOL, RESPONSES
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background: The aim of this study was to compare bupivacaine 0.25% and ropivacaine 0.2%, singly and in combination with ketamine, for caudal administration in children. Duration of analgesia, the need for other analgesics and the stress response were measured.
Abstract

Background: The aim of this study was to compare bupivacaine 0.25% and ropivacaine 0.2%, singly and in combination with ketamine, for caudal administration in children. Duration of analgesia, the need for other analgesics and the stress response were measured. 

Methods: Eighty children were ramdomized into four groups of twenty. The bupivacaine group received bupivacaine 0.25% and the ketamine/bupivacaine group received bupivacaine 0.25% plus 0.5 mg/kg ketamine. The ropivacaine group received ropivacaine 0.2%, and the ketamine/ropivacaine group received ropivacaine 0.2% plus 0.5 mg/kg ketamine. The duration of analgesia and analgesic requirements were recorded for each group, as were peri-operative and post-operative concentrations of the stress hormones insulin, glucose and cortisol. 

Results: Ketamine, added to either bupivacaine or ropivacaine for caudal analgesia, gave a longer duration of analgesia (P < 0.05) than bupivacaine or ropivacaine alone. In all groups, blood insulin concentration was increased, and cortisol concentration reduced. Glucose concentration was significantly increased in all groups (P < 0.05). 

Conclusions: Ketamine can safely be added to ropivacaine 0.2% or bupivacaine 0.25% for caudal anesthesia in order to prolong duration of analgesia and reduce the need for additional analgesics. Stress hormone levels are partially attenuated.