Prolongation of Action of Bupivacaine in Caudal Block in Pediatrics: Comparative Study between Addition of Ketamine, Clonidine and Adrenaline

Regional anesthesia is considered an effective method for providing analgesia both intraoperatively and postoperatively and also decreases the total amount of general anesthesia required for surgery, provides more rapid recovery and faster wake up times. Caudal block is the most useful and common pediatric regional block as it is widely applicable and technically simple. Many factors influence the activity of caudally administrated local anesthetic solutions as dosage, addition of a vasoconstrictor e.g. epinephrine and addition of drugs as Ketamine and Clonidine. In this study, we compared the analgesic efficacy and side effects of Bupivacaine alone, Bupivacaine + Epinephrine, Bupivacaine + Clonidine and Bupivacaine + Ketamine. In the current study the addition of drugs to Bupivacaine has significantly extended the duration of caudal analgesia more than Bupivacaine alone especially with Ketamine and Clonidine.