Background Inflammation and nociceptive sensitization are hallmarks of tissue surrounding surgical incisions. Our studies were directed towards determining if administration ropivacaine with low dose ketamine alter cytokine production after major abdominal operation in newborn with congenital viscero-abdominal disproportion.

Methods A 39 children after major abdominal operation was used to measure the effects of infiltrative administration ropivacaine 0.2% with low dose ketamine (0.1 mg/kg i.v.) administration on cytokine production in blood 45 minutes, 4 hours after operation. We examination 30 patient, undergoing major abdominal operation in children, first group receive combination ropivacaine with low dose ketamine, second group receive morphine (0.1 ml per year). For statistical analysis 2 tests were used.

Results Operative incised abdominal wall displayed profound allodynia which was reduced by ropivacaine with low dose ketamine combination in the 4 hours following incision. Blood samples these patients showed enhanced levels of 3 cytokines: IL-1β, IL-6, tumor necrosis factor alpha (TNFα). Ropivacaine with low dose ketamine administration reduced levels. First group lower cytokines levels over second group (mean ± SD, IL-1β - 4.4 ± 2.2 vs. 14.2 ± 2.4 pg/mg protein; IL-6- 204.8 ± 80.0 vs. 441.2 ± 90.4 pg/mg protein; TNFα - 14.4 ± 4.6 vs. 58.8 ± 7.2 pg/mg) (p<0.001).

Conclusion Ropivacaine with low dose ketamine administration reduces cytokine expression. These studies suggest that Ropivacaine with low dose ketamine combination may alter the inflammatory reaction.