Panda et al. J Biomed & App Sci FUD (2025) 4:2
Keywords: Hemodynamic changes, adverse effects, intravenous paracetamol, intravenous low dose ketamine
2026-03-26 DOI: JOBASFUD_2025_4_2_011
Background: Caudal block using plain bupivacaine provides both intraoperative and postoperative analgesia. However one short coming of single shot caudal bupivacaine is its short duration. In order to prolong the duration of postoperative analgesia, caudal additives or intravenous supplements were used. This study investigated the effect of low dose intravenous ketamine and intravenous paracetamol on the duration of postoperative analgesia produced by caudal bupivacaine in children. Methods: This was a randomized double blind controlled study where 93 ASA I and II children aged 1 to 6 years scheduled for circumcision were randomly allocated to 3 groups. Group BS received 5 ml sterile water intravenously, Group BK received 0.5 mg/kg intravenous ketamine diluted to 5 ml while Group BP received 15 mg/kg of intravenous paracetamol diluted to 5 ml. In all the patients 0.25% plain bupivacaine was used for the caudal blocks under genaral Anaesthesia with LMA and anaesthesia maintained with isoflurane 1.5% in 50% oxygen and 50% air. Pain was assessed postoperatively using the Modified Observational Pain Scale (MOPS) and additional analgesia in form of oral paracetamol 15 mg/kg was given when the Pain score was ≥ 4. Phone call was made to each parent 24 hours after discharge to retrieve the information. Results: There was no statistically significant difference between the groups in terms of preoperative haemodynamic parameters (P =0.596), intraoperative haemodynamic (P = 0.341), incidence of side effects and sedation. Conclusion: Adding low dose ketamine or paracetamol to caudal block can be used to provide good postoperative analgesia without significant side effects in children.