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British Journal of Anaesthesia, 2003, Vol. 91, No. 2 300-301
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Correspondence

Caudal additives in children—solutions or problems?

M. Martindale1, M. Worsley1, M. Thomas2 and D. de Beer2

1 Stirling, UK 2 London, UK

Editor—We congratulate Drs de Beer and Thomas on their excellent review on caudal additives,1 and agree with their support for the use of ketamine. As they say, it is likely that problems with the availability of preservative-free ketamine have prevented this technique from becoming more popular in Britain. We thought your readers might be interested to know that rather than being completely unavailable, however, preservative-free ketamine (Ketamine, Curamed®) can be obtained from IDIS World Medicines, Surbiton, UK, with a lead time of 5 days. A data sheet in English and a certificate of analysis is available if requested.

We have secured a supply in this way and find, as the authors suggest, that ketamine 0.5 mg kg–1 added to bupivacaine is highly effective in improving the quality and duration of the analgesia, without problems of motor block or other side-effects.

M. Martindale

M. Worsley

Stirling, UK

Editor—We thank Martindale and Worsley for their letter, and the editor for the opportunity to respond.

As they correctly quote,1 we consider that the lack of readily available preservative-free ketamine (Ketamine, Curamed®) has hitherto been a barrier to its wider use. At the time of writing the review, we were only aware of one company in Germany who was able to supply the preservative-free form. We thus read with interest that the agent is now available in the UK, at relatively short notice. We look forward to more data becoming available on its side-effect profile as its clinical use inevitably increases.

M. Thomas

D. de Beer

London, UK

References

1 de Beer DAH, Thomas ML. Caudal additives in children—solutions or problems? Br J Anaesth 2003; 90: 487–98[Abstract/Free Full Text]


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