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An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

European Journal of Pharmaceutical and Medical Research (EJPMR) has indexed with various reputed international bodies like : Google Scholar , Indian Science Publications , InfoBase Index (In Process) , SOCOLAR, China , Research Bible, Fuchu, Tokyo. JAPAN , International Society for Research activity (ISRA) , Scientific Indexing Services (SIS) , Polish Scholarly Bibliography , Global Impact Factor (GIF) (Under Process) , Universal Impact Factor , International Scientific Indexing (ISI), UAE  , Index Copernicus , CAS (A Division of American Chemical Society) USA (Under Process) , Directory of Open Access Journal (DOAJ, Sweden, in process) , UDLedge Science Citation Index , CiteFactor , Directory Of Research Journal Indexing (DRJI) , Indian citation Index (ICI) , Journal Index (JI, Under Process) , Directory of abstract indexing for Journals (DAIJ) , Open Access Journals (Under Process) , Impact Factor Services For International Journals (IFSIJ) , Cosmos Impact Factor , Jour Informatics (Under Process) , Eurasian Scientific Journal Index (ESJI) , International Innovative Journal Impact Factor (IIJIF) , Science Library Index, Dubai, United Arab Emirates , Pubmed Database [NLM ID: 101669306] (Under Process) , IP Indexing (IP Value 2.40) , Web of Science Group (Under Process) , Directory of Research Journals Indexing , Scholar Article Journal Index (SAJI) , International Scientific Indexing ( ISI ) , 

 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57



Dr. Ayman Aly Rayan MD*, Dr. Wesam Eldeen Sultan, MD and Dr. Hosni Aly Salem, MD


Background: Different additives have been reported to prolong the duration of caudal anesthesia in pediatrics. Although these drugs successfully increased the duration of the block. Ketamine has been found to effectively increase the duration of caudal block in pediatrics. The aim: This study aimed to assess the clinical effectiveness of ketamine after caudal or intravenous administration in pediatric patients that underwent hypospadias repair to distinguish between local and systemic analgesia. Methods: After induction of general anesthesia, 48 patients, aged 1-6 years, assigned to undergo hypospadias repair, received a caudal injection of bupivacaine and were randomly blinded into two groups: K1 group received 1 mg/kg S ketamine as the caudal group and K2 group received 1 mg/kg S ketamine as the intravenous group. Postsurgical measurements included the effectiveness of postsurgical analgesia, which was assessed by using observational pain scale (OPS), duration of analgesia, sedation score, and hemodynamic and complications. Results: The caudal block was successful in all the patients included in the study. None of the patients in either groups required intraoperative rescue analgesia. All patients remained vitally stable during the procedure and intraoperative hemodynamic parameters were comparable in the two groups. The time to the administration of first analgesia was statistically longer in K1 group (11.5 ± 4.6h) than in the K2 group (8.7 ± 3.1h). Time to spontaneous leg movement and time to first micturition were statistically non-significant between both groups. Number of patients requested for additional analgesic drugs (acetaminophen and ibuprofen) was statistically significant being higher in the K2 group than the K1 group. Conclusion: In conclusion this study demonstrates that ketamine if added to caudal epidural in a dose of 1 mg/kg provided prolonged postoperative analgesia with improved quality, longer duration, decreased the supplemental acetaminophen analgesia during the first 24 h postoperatively with stable hemodynamic changes and comparable side effects and complications in comparison to systemic ketamine in a dose of 1 mg/kg.

Keywords: Caudal, ketamine, hypospadias, pediatrics.

[Full Text Article]



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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI )