Caudal block using Ropivacaine with or without Tramadol in children for lower abdominal and lower limb surgery

Abstract

Background: Caudal anaesthesia is a useful adjunct to general anaesthesia for lower abdominal surgery in children as it provides intraoperative analgesia, smooth recovery period and good post-operative pain control which reduces Perioperative narcotic requirements. Aims & Objective: This Study was designed to evaluate duration of analgesia of Ropivacaine and Ropivacaine with Tramadol administered caudally for postoperative pain relief in children. Materials and Methods: Study was conducted in 60 paediatric patients of either sex belonging to ASA grade I or II in the age group 1 to 6 years scheduled for elective lower abdominal and lower limb surgery. Patients were randomly selected by sealed envelope method and divided into two groups of thirty patients each. Group RS received 0.2% Ropivacaine, 1 ml/kg with saline 0.04 ml/kg and Group RT received 0.2% Ropivacaine, 1 ml/kg with Tramadol 2 mg/kg by caudal route immediately after induction of general anaesthesia. Vitals and oxygen level was monitored. The analgesic effect of the caudal block was evaluated by using the observational Pain discomfort Scale and Four Point Sedation Score was used for assessment of sedation after extubation at 30 minutes and at 1, 2, 4, 6, 12 and 24 hrs. The time for the first analgesic requirement and side effects in 24 hours period were recorded. Results: Duration of analgesia was longer in Group RT [19.21 ± 2.25 hours] as compared to Group RS [6.38 ± 0.897 hours] (p<0.01). There were no significant changes in heart rate, blood pressure and oxygen saturation between two groups. Conclusion: Caudal Tramadol 2 mg/kg, combined with 0.2% Ropivacaine, 1ml/kg, provides longer duration of postoperative analgesia as compared to 0.2% Ropivacaine alone in children undergoing lower abdominal and lower limb surgery.