Author(s):
1. Noor Un Nisa:
Department of Anesthesiology,Shaikh Zayad Hospital,Lahore,Pakistan
2. Saqib Butt:
Department of Anesthesiology, Islamabad Medical & Dental College, Islamabad (Pakistan
3. Hasham Khan:
Niazi Teaching Hospital, Islamabad (Pakistan
4. Ghulam Mustafa:
Medical & Dental College,Islamabad (Pakistan
Abstract:
Millions of children receive sedative, anesthetic and analgesic drugs for surgeryworldwide. Caudal epidural block with bupivacaine is widely used for perioperativeanalgesia in children undergoing surgeries under general anesthesia. Current study aimsto determine postoperative pain relief and side effects due to caudally administered0.25% bupivacaine (0.5-1 ml/kg) alone and a combination of 0.25% bupivacaine (0.5-1ml/kg) with tramadol (1 mg/kg).Methodology: A randomized clinical trial was conducted at department of Anesthesiology,Shaikh Zayed Hospital, Lahore. Study duration was 1 year and 6 months (February2015-August 2016). A sample size of 108 patients was calculated using WHO calculator.Non probability consecutive sampling was used. Patients were randomly divided into twogroups; Group B was given inj. bupivacaine 0.25% while Group BT received a combinationof 0.25% bupivacaine (0.5-1 ml/kg) with tramadol (1 mg/kg). Patients were observed forsedation score, FLACC pain score and adverse effects in both interventional groups. Datawere analyzed using SPSS version 22. Student’s T-test was applied on data. P-value = 0.05
was considered significant.
Results: Total 108 patients were included in the study (1:1 randomization). Mean
age of patients was 6.41 ± 1.77 y. There were 92 (85.2%) male and 16 (14.8%) female
children. Mean sedative scores (p = 0.00) and mean FLACC pain scores (p = 0.000) were
significantly lower in bupivacaine tramadol group as compared to bupivacaine group.
However, bupivacaine group had more adverse effects as compared to combination of
bupivacaine and tramadol group.
Conclusion: Caudal epidural with a combination of 0.25% bupivacaine (0.5-1 ml/kg) with
tramadol (1 mg/kg) has high postoperative analgesic efficacy and limited adverse effects
as compared to 0.25% bupivacaine alone in children undergone general anesthesia for
lower abdominal surgery.
Page(s):
279-283
DOI:
DOI not available
Published:
Journal: Anaesthesia, Pain and Intensive Care, Volume: 23, Issue: 3, Year: 2019
Keywords:
Analgesia
,
Bupivacaine
,
tramadol
,
Sedation score
,
Caudal epidural block
,
FLACC score
References:
References are not available for this document.
Citations
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