Comparative study of caudal Ropivacaine with ropivacaine & Ketamine for postoperative analgesia in paediatric patients

Objective: Objective of this study was to determine the efficacy of caudal Ketamine added to ropivacaine in providing postoperative analgesia in pediatric age group. Materials and Method: This was a prospective randomized double blind study carried out in 60 ASA grades I/II children (2-9years) posted for below umbilical surgeries over a period of 2 years. They were randomized into two groups of 30 each. Group A received caudal ropivacaine 0.25% (1ml/kg) & Group B received caudal ropivacaine 0.25% (1ml/kg) with Ketamine (0.5mg/kg).The parameters studied were intraoperative hemodynamic changes, duration of postoperative analgesia and incidence of complications. Result: The mean duration of post-operative analgesia was significantly higher in Group B (395.26±55.97 minutes) than in group A (217.66±30.42 minutes), p = 0.000. The perioperative hemodynamic parameters were stable and comparable in both the groups.Incidence of vomiting in group A was 6.6 % and 10% in group B, the difference being statistically insignificant. None of the patients in both the groups had bradycardia, hypotension and delirium. Conclusion: The present study demonstrated that caudal administration of ropivacaine 0.25% (1 ml/kg) with Ketamine (0.5 mg/kg) results in longer duration of analgesia compared with 0.25% ropivacaine (1 ml/kg) alone, without any significant side-effects.