Abstract
Background: Our aim was to compare caudal epidural versus general anaesthesia in paediatric patients for safety, efficacy, post-operative analgesia, cost effectiveness and surgeons comfort.Material and Methods: 60 paediatric patients 2 -6 years of ASA grade I and II posted for infra-umbilical surgery were randomly divided in to two groups. Group C (n=30) received caudal block anaesthesia using 0.25% Ropivacaine 1ml kg -1. Group G (n=30) received general anesthesia with Thiopentone sodium, Succinylscoline as induction agent and O2, N2O, Isoflurane and incremental doses of Atracurium as maintenance. They were extubated in a usual manner after surgery. In both groups pain was assessed by observer pain score.Observation and Results: Cost was less in group C. There was no significant change in hemodynamics in both groups. Duration of rescue analgesia was significant less in group G. Rate of post-operative complication was higher in group G. caudal anaesthesia was much accepted by surgeon.Conclusion: Caudal epidural is quite inexpensive with excellent anaesthesia and satisfactory post-operative analgesia with lesser complication rate.
Highlights
Caudal epidural is one of the most common regional techniques used for post-operative pain management in paediatric patients[1]
The use of regional anaesthesia in combination general anaesthesia results in reduced concentration of potent inhaled agents and reduced or absent use of opioids resulting in quick recovery time and less nausea and vomiting
Regional anaesthesia suppresses the neuroendocrine responses to surgery compared with general anaesthesia alone
Summary
Caudal epidural is one of the most common regional techniques used for post-operative pain management in paediatric patients[1]. It is commonly used for procedures like urogenital, rectal, inguinal and lower extremity surgeries[2]. Our aim was to compare caudal epidural versus general anaesthesia in paediatric patients for safety, efficacy, post-operative analgesia, cost effectiveness and surgeon’s comfort. Group G (n=30) received general anesthesia with Thiopentone sodium, Succinylscoline as induction agent and O2, N2O, Isoflurane and incremental doses of Atracurium as maintenance. They were extubated in a usual manner after surgery.
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