S(+)-ketamine for caudal block in paediatric anaesthesia

We have evaluated the intra- and postoperative analgesic efficacy of preser vative-free S(+)-ketamine compared with bupivacaine for caudal block in pae diatric hernia repair. After induction of general anaesthesia, 49 children undergoing hernia repair were given a caudal injection (0.75 ml kg(-1)) of S(+)-ketamine 0.5 mg kg(-1) (group K1), S(+)-ketamine 1.0 mg kg(-1) (group K2) or 0.25% bupivacaine with epinephrine 1:200 000 (group B). No additiona l analgesic drugs were required during operation in any of the groups. Haem odynamic and respiratory variables remained stable during the observation p eriod. Mean duration of analgesia was significantly longer in groups B and K2 compared with group K1 (300 (SD 96) min and 273 (123) min vs 203 (117) m in; P<0.05). Groups B and K2 required less analgesics in the postoperative period compared with group K1 (30% and 33% vs 72%; P<0.05). Postoperative s edation scores were comparable between the three groups. We conclude that S (+)-ketamine 1.0 mg kg(-1) for caudal block in children produced surgical a nd postoperative analgesia equivalent to that of bupivacaine.