Review of clinical evidence of caudal block for postoperative analgesia in children with ketamine added local anesthetics

Amanuel Sisay Endeshaw; Esubalew Muluneh Aligaz; Misganew Terefe Molla; Befekadu Amare Mekonnen; Abdi Tariku Tesema; Tesfaye Abebe Dinku; Kirubel Behailu Atero; Tsion Lemma Regassa

doi:10.1016/j.amsu.2022.103480

Review of clinical evidence of caudal block for postoperative analgesia in children with ketamine added local anesthetics

Ann Med Surg (Lond). 2022 Mar 8:75:103480. doi: 10.1016/j.amsu.2022.103480. eCollection 2022 Mar.

Authors

Amanuel Sisay Endeshaw¹, Esubalew Muluneh Aligaz¹, Misganew Terefe Molla¹, Befekadu Amare Mekonnen², Abdi Tariku Tesema², Tesfaye Abebe Dinku³, Kirubel Behailu Atero⁴, Tsion Lemma Regassa⁵

Affiliations

¹ Department of Anesthesia, College of Medicine and Health Science, Bahirdar University, Bahirdar, Ethiopia.
² Department of Anesthesiology, College of Medicine and Health Science, Dilla University, Ethiopia.
³ Department of Anesthesia, Adama Hospital Medical College, Adama, Ethiopia.
⁴ Department of Anesthesia, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
⁵ Department of Anesthesia, Saint Peter Specialized Hospital, Addis Ababa, Ethiopia.

Abstract

Background: Adding ketamine to local anesthetics used for caudal block in children is an emerging clinical practice. This review aims to resolve controversies related to this adjuvant for a caudal block in children who underwent sub-umbilical surgeries.

Methods: Between January 2010 and November 2021, PubMed, Cochrane Review, and Google Scholar were searched for a caudal block with ketamine added local anesthetics for children. After screening for eligibility and removing duplicates, 38,187 articles were found, 13 reviewed.

Discussion: Despite adding ketamine to local anesthetics used for a caudal block, it is a recent technique practiced worldwide. Ketamine showed equi-efficacious as other adjuvants used for the caudal block to control postoperative pain in children.

Conclusion: Ketamine with a 0.5 mg/kg dose is safe and effective to manage postoperative children's pain when used as an adjuvant to local anesthetics used for caudal block.

Keywords: Caudal analgesia; Ketamine adjuvant; Ketamine-added caudal block; Pediatric postoperative pain.

Publication types

Review