Abstract
Background: The goal of postoperative analgesia is to minimise pain with least possible side effects and in our setting be as cost effective as possible. In children, caudal anaesthesia is typically combined with general anaesthesia for intraoperative and postoperative analgesia. Adjuvants can be added to local anaesthetics for prolonging the duration of analgesia. This study was done to find out the duration of analgesia of caudal Bupivacaine in combination with Tramadol.Methods: This prospective, randomised, double-blind, comparative study was done by taking a total of 60 patients, aged between 2 to 7 years undergoing elective lower abdominal, urological and lower extremity surgeries. The patients were randomized to group A (n=30) receiving 1 ml/kg of 0.25% bupivacaine and group B (n=30) receiving 1 ml/kg of 0.25% bupivacaine plus 1mg/kg of tramadol caudally. Duration of analgesia, hemodynamic responses and adverse effects were noted and analysed.Results: Thirty patients in both groups were comparable with regard to demographic data and hemodynamic response and were statistically non-significant (P>0.05). It was observed that the mean duration of analgesia was significantly longer in group B (467.5±164.5 min versus 240.5±69.4 min, P<0.001). One patient in each group had postoperative vomiting.Conclusion: Tramadol 1mg/kg as an adjuvant to bupivacaine 0.25% for caudal analgesia in children is effective in increasing the duration of analgesia without an increase of adverse effects.
Highlights
The society of Paediatric Anaesthesia, on its 15th annual meeting at Louisiana clearly defined the alleviation of pain as a “basic human right”,1 irrespective of age, medical condition, treatment or medical institution
Efficacy of tramadol as an adjuvant to bupivacaine for caudal analgesia in children: a randomised controlled trial
Various regional anaesthetic procedures have gained popularity for postoperative analgesia because in addition to provide analgesia, they reduce the need of general anaesthetic intra-operatively without significant adverse effects and maintain a smooth intraoperative as well as postoperative period
Summary
The society of Paediatric Anaesthesia, on its 15th annual meeting at Louisiana clearly defined the alleviation of pain as a “basic human right”,1 irrespective of age, medical condition, treatment or medical institution. Caudal anaesthesia is typically combined with general anaesthesia for intraoperative supplementation and postoperative analgesia. It is commonly used for surgical procedures below the diaphragm like urogenital, rectal, inguinal, and lower extremity.[2]. The main drawback of caudal analgesia is the short duration of action with a local anaesthetic agent in a single injection. To overcome this problem, various drugs can be added to local anaesthetics as an adjuvant to prolong the duration of analgesia. Caudal anaesthesia is typically combined with general anaesthesia for intraoperative and postoperative analgesia.
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