The benefit of small doses of ketamine has been demonstrated for postoperative analgesia in
adults but remains unproved in children. The investigators' purpose is to evaluate the
effects of continuous intravenous small doses of ketamine versus placebo to improve the
quality of postoperative analgesia in children (6 months to 6 years of age). Caudal
anesthesia is performed for intraoperative analgesia and all children receive paracetamol, a
non-steroidal anti-inflammatory and continuous intravenous nalbuphine.
Nalbuphine for the Treatment of Opioid Induced Pruritus in Children
University of British Columbia
Itching is a frequent and disturbing side effect of the use of pain medication such as
morphine. In the post-operative period, it can be more distressing to pediatric patients than
their pain. The current first line treatment, an antihistamine (Benadryl), has a low
efficacy. This treatment causes sleepiness and may be dangerous when used in combination with
Nalbuphine has analgesic properties similar to morphine as well as the ability to reverse
some morphine-induced side effects, such as respiratory depression and itching. Nalbuphine
has been used effectively for patients undergoing Caesarean sections. However, the
effectiveness of nalbuphine in the pediatric population has not been investigated.
We want to determine the efficacy of nalbuphine in the treatment of itching after morphine
for postoperative pain relief. We will use a novel method to measure the effect of the
treatment using an intensity scale before and after the drug, to determine the intensity
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