scholarly journals Comparison of single shot caudal Ropivacaine and Bupivacaine in paediatric patients undergoing herniotomy

2019 ◽  
Vol 1 (2) ◽  
pp. 73-76
Author(s):  
Rishabh Ravi ◽  
Bigen Man Shakya ◽  
Anil Shrestha
Keyword(s):  
Motor Block ◽  
Complete Recovery ◽  
Pain Scale ◽  
P Value ◽  
Single Shot ◽  
Caudal Block ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B

Background: Inguinal hernia repair is a common surgical procedure in children. Caudal block is an appropriate technique for the treatment of post operative pain in children undergoing herniotomy. This study compared the effects of Ropivacaine and Bupivacaine in caudal block in children undergoing herniotomy. Methodology: A total of 74 patients between 5-16 yrs undergoing herniotomy were randomized in two groups. In Group B, 0.75ml/kg of 0.25% caudal Bupivacaine was administered whereas Group R received 0.75 ml/kg of 0.25% caudal Ropivacaine. Pain score was assessed using Wong Baker pain scale in post operative period and motor power was assessed using modified Bromage scale till 6 hours. Results: The mean duration of post operative analgesia was found to be 253.51 ± 11.48 minutes in Bupivacaine and 258.1 ± 12.10 minutes in Ropivacaine group. The median duration of motor block was 180 (Q1 60- Q3 180) minutes in Bupivacaine and 30 (Q1 22.5- Q3 45) minutes in Ropivacaine group which was statistically significant. There was complete recovery of motor block by 2 hour in Ropivacaine and by 4 hour in Bupivacaine group. (p value< 0.001). Conclusion: From the current study, it is concluded that caudal Ropivacaine at 0.25% concentration and 0.75ml/ kg provides similar duration of post operative analgesia with less motor block in comparison to Bupivacaine.

scholarly journals Penile nerve block at the base of penis in combination with intravenous ketamin plus midazolam versus general anaesthesia(GA) in children undergoing circumcision for post operative pain management in the Eastern Nepal

2014 ◽  
Vol 4 (1) ◽  
pp. 33-36
Author(s):  
NR Sharma ◽  
P Timalsena ◽  
U Rai
Keyword(s):  
Pain Management ◽  
General Anaesthesia ◽  
Nerve Block ◽  
Randomized Study ◽  
Pain Scale ◽  
Single Shot ◽  
Post Operative Pain ◽  
Analgesia Requirement ◽  
Group A ◽  
Group B

Adequate post operative analgesia in children provides satisfactory psychological objective of this study was to compare the post operative analgesia requirement and child satisfaction between two groups, general anaesthesia(GA) alone and GA in combination with penile nerve block. This prospective randomized study was conducted in 50 children aged 6 to 14 years, who underwent circumcision. The boys were randomly allocated into two groups. Group A (n = 25) received GA with Single shot ketamin 2mg/kg IV plus midazolam 0.1 mg/kg and dorsal penile nerve block at the base of penis prior to circumcision with and Group B (n = 25) received GA with ketamine 2mg/kg IV plus midazolam 0.1 mg/kg plus halothane by laryngeal mask. Severity of pain was assessed quantitatively by children’s hospital eastern Ontario pain scale (CHEOPS). The pain intensity was assessed at one hour A1 in group A and B1 for group B and at two hour A2 for group A and B2 for group B during postoperatively period for two hours. Statistical analysis was done by SPSS method. The post operative analgesia was satisfactory with CHEOPS score 6 or <6 in group A 1. In group A 2 twenty two out of twenty five cases had CHEOPS score <6.Where as in group B1 and B2 it was > 6 .Which was statistically 100% significant. In conclu­sion, combined penile nerve block in combination with intravenous ketamine plus midazolam is the satisfactory method of Post operative pain management in children undergoing circumcision. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10846 Journal of Chitwan Medical College 2014; 4(1): 33-36

P91 Post-operative pain in neurosurgery

2019 ◽  
Vol 90 (3) ◽  
pp. e46.1-e46
Author(s):  
PM Haigh ◽  
F Al-Hatimi ◽  
H Stewart ◽  
S Rajagopal ◽  
S Khalifa ◽  
...  
Keyword(s):  
Pain Score ◽  
Spinal Surgery ◽  
Foramen Magnum ◽  
P Value ◽  
Inflammatory Agent ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean

ObjectivesAre the analgesic guidelines for those neurosurgical operations associated with major and complex major pain consistently followed? Is there a correlation between adherence and post-operative pain?DesignPatients undergoing spinal surgery and foramen magnum decompressions were visited on the first post-operative day (D1). They provided their pain score subjectively (0=nil; 10=worst ever experienced); objectively we recorded whether they could move in/out of bed without pain limitation.Subjectsn=57 consecutive patients undergoing elective major and complex major pain neurosurgery between April and June 2018 at the NHNN, Queen Square.MethodsA proforma was completed on D1. The patients consented to take part and answered three questions. We examined what (if any) analgesics they were admitted on, and what had been prescribed to cover the post-operative period. This was compared against the appropriate guideline for that category of operation.ResultsGuidelines were only followed in 16/57 (28.1%) cases; not followed in 41/57 (71.9%). On an unpaired T-test: 2-tailed P value=0.0195. Where guidelines were followed, the mean pain score reported was: 3.75 (SD 2.72) Where not followed, the mean pain score was 5.46 (SD 2.29). So with a 95% confidence interval −3.41 to −0.29, there is a significant difference between the pain in those prescribed according to the guidelines and those that were not.ConclusionsThe pain guidelines are not routinely followed. Most commonly this was due to no prescription for a non-steroidal anti-inflammatory agent. We suggest regular sessions of education of the guidelines. Cycle 2 closed the loop of the audit. We re-reviewed adherence and pain scores and found guidelines were followed in 34% of cases, which represented a 6% improvement. On a paired two-tailed P value=0.0794. The mean pain score where guidelines were followed=3.42 (SD1.62) against a mean=4.74 (SD 1.89) where guidelines were not followed.

scholarly journals A COMPARATIVE STUDY OF CAUDAL BUTORPHANOL AND FENTANYL FOR ALLEVIATING POST-OPERATIVE PAIN IN INFRAUMBILICAL PROCEDURES IN CHILDREN BELOW 3 YEARS OF AGE

2019 ◽  
Vol 12 (1) ◽  
pp. 336
Author(s):  
Mohammed Irfanulla ◽  
Thrivikram Shenoy ◽  
Ranjan Rk
Keyword(s):  
Analgesic Efficacy ◽  
Anesthetic Technique ◽  
Caudal Block ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B ◽  
Fentanyl Group ◽  
Caudal Blockade

Objective: Caudal block is a common regional anesthetic technique used in children. However, it is limited by relatively shorter duration of analgesia. The objective of this study was to compare the analgesic efficacy of caudal blockade using butorphanol (1) and fentanyl in children below 3 years, undergoing infraumbilical surgeries.Methods: Patients were randomly allocated to two groups of 30 each. Without premedication, patients were induced with thiopentone, relaxed with atracurium for facilitation of LMA insertion, and maintained on O2, N2O, and halothane. Caudal block was then performed using an aseptic technique. One group received caudal butorphanol (25 μg/kg) with 0.25% bupivacaine (0.1 ml/kg) and the other received fentanyl (1 μg/kg). Incision was allowed after 15 min of block. After the completion of surgery, LMA was removed and patients were shifted to the PACU. Non-invasive blood pressure and heart rate were recorded; pain was assessed using modified objective pain score (MOPS) (2) at 2, 4, 6, 12, and 24 h, postoperatively. Oral paracetamol was given at a score >4.Results: The mean duration of analgesia in Group F was 12.47 (standard deviation [SD] 8.216) and 19.67 (SD 7.009) in Group B (p: 0.001, HS). Mean MOPS was 4.6 in the fentanyl group as compared to 2.6 in the butorphanol group at the end of 24 h (p=0.001, HS). Thus, butorphanol provided longer duration of analgesia compared to fentanyl.Conclusion: Caudal additives are safe in children and butorphanol provides significantly longer duration of analgesia as compared to fentanyl, thus avoiding caudal catheterization and intravenous analgesics.

scholarly journals A COMPARATIVE STUDY OF CAUDAL BUTORPHANOL AND FENTANYL FOR ALLEVIATING POST-OPERATIVE PAIN IN INFRAUMBILICAL PROCEDURES IN CHILDREN BELOW 3 YEARS OF AGE

2019 ◽  
Vol 12 (1) ◽  
pp. 336
Author(s):  
Mohammed Irfanulla ◽  
Thrivikram Shenoy ◽  
Ranjan Rk
Keyword(s):  
Analgesic Efficacy ◽  
Anesthetic Technique ◽  
Caudal Block ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B ◽  
Fentanyl Group ◽  
Caudal Blockade

Objective: Caudal block is a common regional anesthetic technique used in children. However, it is limited by relatively shorter duration of analgesia. The objective of this study was to compare the analgesic efficacy of caudal blockade using butorphanol (1) and fentanyl in children below 3 years, undergoing infraumbilical surgeries.Methods: Patients were randomly allocated to two groups of 30 each. Without premedication, patients were induced with thiopentone, relaxed with atracurium for facilitation of LMA insertion, and maintained on O2, N2O, and halothane. Caudal block was then performed using an aseptic technique. One group received caudal butorphanol (25 μg/kg) with 0.25% bupivacaine (0.1 ml/kg) and the other received fentanyl (1 μg/kg). Incision was allowed after 15 min of block. After the completion of surgery, LMA was removed and patients were shifted to the PACU. Non-invasive blood pressure and heart rate were recorded; pain was assessed using modified objective pain score (MOPS) (2) at 2, 4, 6, 12, and 24 h, postoperatively. Oral paracetamol was given at a score >4.Results: The mean duration of analgesia in Group F was 12.47 (standard deviation [SD] 8.216) and 19.67 (SD 7.009) in Group B (p: 0.001, HS). Mean MOPS was 4.6 in the fentanyl group as compared to 2.6 in the butorphanol group at the end of 24 h (p=0.001, HS). Thus, butorphanol provided longer duration of analgesia compared to fentanyl.Conclusion: Caudal additives are safe in children and butorphanol provides significantly longer duration of analgesia as compared to fentanyl, thus avoiding caudal catheterization and intravenous analgesics.

A Novel Distraction Technique for Pain Management during Local Anesthesia Administration in Pediatric Patients

2013 ◽  
Vol 38 (1) ◽  
pp. 45-47 ◽  
Author(s):  
PS Kamath
Keyword(s):  
Local Anesthesia ◽  
Pediatric Patients ◽  
Control Method ◽  
Dental Treatment ◽  
Intervention Group ◽  
Pain Scale ◽  
Control Group ◽  
P Value ◽  
Post Operative Pain ◽  
The Mean

Aim: The aim of this study was to assess the effect of an active and novel distraction technique WITAUL (Writing In The Air Using Leg) on the pain behavior observed and reported by children receiving local anesthesia injections prior to dental treatment. Study design: The study was conducted on 160 children (80 in control and 80 in intervention group) between the ages of 4 - 10 years. During the administration of anesthesia the children in the control group were made to relax by means of deep breathing and those in the intervention group were taught to use the WITAUL distraction technique. the behavior of the children aged 4 - 5 years was noted using the Modified Toddler-Preschooler Post operative Pain Scale (TPPPS) and that of children aged above 6 years was measured using the FACES Pain Scale-Revised (FPS-R). Results: The use of WITAUL was found to be statistically significant (p value &lt; 0.0001) compared to the control method in serving as a distraction and hence in managing pain during local anesthesia administration. The mean Modified TPPPS scores (4 - 5 year olds) for the WITAL group was 2.46 ±1.752 and that of the control was 5.64±2.328. The mean FPS-R scores (6 - 10 year olds) for the WITAUL group was 3±1.748 and that of the control group was 6.26±1.858. Conclusion: The WITAUL technique therefore appears to be a simple and effective method of distraction during local anesthesia administration in pediatric patients.

scholarly journals ROLE OF LOCAL INFILTRATION OF INJECTION BUPIVACAINE IN REDUCING EARLY POST-OPERATIVE PAIN

2020 ◽  
Vol 11 (1) ◽  
pp. 1-8
Author(s):  
Mudassar jabeen ◽  
Fawad Zafar ◽  
Sumara Tabassam ◽  
Farhad Alam ◽  
Muhammad Sohail
Keyword(s):  
Controlled Trial ◽  
Pain Scale ◽  
Control Group ◽  
P Value ◽  
Local Infiltration ◽  
Surgical Incision ◽  
Surgical Department ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference

ABSTRACT: BACKGROUND & OBJECTIVE: Intolerable morbidity occurs after major thoracic, orthopedic or abdominal surgeries due to post-operative pain. Inadequately controlled pain leads to patient displeasure and major morbidities like postoperative pulmonary dysfunctions and cardiac ischemic changes. Various techniques are presently used to treat this pain and opiods are the most regularly used medications by parenteral or neuraxial route. Intolerable morbidity occurs post-operatively due to inadequately controlled pain. The objective of this study was to compare the mean pain scores in patients undergoing laparotomy with and without local infiltration of injection bupivacaine at surgical incision site in post-operative period. METHODOLOGY: This randomized controlled trial was conducted at surgical department Allied hospital Faisalabad from June 2017 to December 2017.Total 80 patient were included in this study that were randomly divided into two groups using random number tables. In post-operative period, patients of both groups were given treatment as per requirement of their respective diseases. They received a baseline analgesia using Inj. Toradol (ketorolac) 30mg/1ml intravenously every 8 hours, first dose given during the surgery. The study group was additionally given 10ml Inj. Bupivacaine HCl 0.5% diluted with 10ml saline injected into the subcutaneous plane around the incision immediately after the closure of skin and time was noted. No further difference in the treatment of patients of both groups required for the purpose of this study. The patients in both groups were compared for the degree of pain experienced by them in early post-operative period. This information was collected using Numeric pain scale, 10 being worst pain and 1 meaning least appreciable pain. These assessments were done 2 and 4 hours after surgery. RESULTS: We recorded pain score 3.0+0.75 in study and 5.2+0.72 in control group, p-value was < 0.001 showing a significant difference. CONCLUSION: We concluded that there is significantly lower pain in patients infiltrated with injection bupivacaine around surgical incision in early post-operative period as compared to those who had only intravenous analgesics.

scholarly journals Comparative Study of Caudal Bupivacaine and Bupivacaine with Clonidine in Infra Umbilical Surgeries in Children

2020 ◽  
Vol 5 (1) ◽  
pp. 23-29
Author(s):  
Swetha J Gouda ◽  
P.V. Margi
Keyword(s):  
Side Effects ◽  
Single Shot ◽  
Age Group ◽  
Efficacy And Safety ◽  
Caudal Block ◽  
Hemodynamic Changes ◽  
Analgesic Effects ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Caudal epidural analgesia is one of the most commonly performed regional blocks in paediatric anaesthesia for intra and post-operative analgesia. Addition of opioids like morphine, fentanyl is associated with side effects like respiratory depression, urinary retention, etc. Clonidine, an α2 agonist is known for its analgesic effects with lesser side effects. Hence, this study was conducted to know the efficacy and safety of addition of clonidine to bupivacaine in a single shot caudal block in children.Subjects and Methods:This study was conducted among 60 children in the age group of 5 – 10 years coming for various elective infraumbilical surgical procedures. They were divided into two groups of 30 each. Group A received caudal 0.25% bupivacaine (1ml/kg) and group B received caudal 0.25% bupivacaine (1ml/kg) with clonidine (1.5µg/kg). The various parameters studied were hemodynamic changes, duration of analgesia and incidence of side effects.Results:The groups were similar in age, sex and weight. The hemodynamic parameters like heart rate, blood pressure, respiratory rate were also similar between the two groups after administering caudal block. The mean duration of analgesia in group B (433.5 ± 60 min) was significantly longer (p< 0.05) than group A (250.33 ±41 min). Conclusion:This study showed that the addition of clonidine in the dose of 1.5µg/kg to 0.25% bupivacaine (1ml/kg) improved the analgesic duration and efficacy after a single shot caudal block with minimal side effects in children.

Comparison of Analgesic Efficacy of Nalbuphine Versus Tramadol as Adjuvant to Local Anaesthetic in Caudal Block in Children

2021 ◽  
Vol 15 (11) ◽  
pp. 3458-3460
Author(s):  
Muhammad Sharif ◽  
Muhammad Arif Baloch ◽  
Nazeer Ahmed ◽  
Zafar ullah ◽  
Yasir Reda Toble
Keyword(s):  
Group Versus ◽  
Analgesic Efficacy ◽  
P Value ◽  
Caudal Block ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
Mean Time

Objective: To compare the mean time of first analgesia with nalbuphine versus tramadol as adjuvant to bupivacaine for caudal block in children. Patients and Methods: In this randomized clinical trial, a total number of 60 children who were planned for caudal block after infra-abdominal surgeries having age 3-12 years were included. A caudal block was performed under general anaesthesia immediately after surgery for postoperative analgesia. Tramadol 2mg/kg body weight was given caudally to individuals in group A. Group B patients had 0.125 percent bupivacaine with 0.1mg/kg nalbuphine caudally. Time of requirement of first analgesia was noted in all patients. Paracetamol 10 mg/kg was given as rescue analgesic in all patients. Results: Mean age of patients was 8.30±3.03 years. Mean weight of patients was 23.33±6.92 Kg. There were 26 (43.33%) female patients and 34 (56.67%) male patients. There were 50 (83.33%) children who were having ASA status I, and remaining 10 (16.67%) children were having ASA status II. Mean pain score was 3.53±1.43 in tramadol group and 1.86±1.25 in Nalbuphine group (p-value <0.001. Mean time of first rescue analgesia was significantly prolonged in Nalbuphine group, mean time was 6.13±1.07 hours in Nalbuphine group versus 4.03±1.03 hours in tramadol group (p-value <0.001). Conclusion: Single dose of nalbuphine as an adjunct to bupivacaine is superior as compared to tramadol in reducing the post-operative pain, it also significantly prolongs the duration of analgesia in children. Keywords: Caudal Block, Nalbuphine, Tramadol, Post-operative pain, Time of first rescue analgesia.

scholarly journals Caudal bupivacaine - midazolam for post operative analgesia in children

2014 ◽  
Vol 23 (1) ◽  
pp. 8-13
Author(s):  
Idris Ali ◽  
Amirul Islam ◽  
Golam Morshed ◽  
Nurul Islam ◽  
Ashia Ali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Anaesthetic Agent ◽  
Caudal Block ◽  
Arterial Blood ◽  
Post Operative Period ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Group B

Background: Adjuvant used with local anaesthetic agent in caudal is more effective for post operative analgesia in children . Aim and objective: To find out the duration and quality of caudal analgesia in children undergoing genitourinary surgery by combination of bupivacaine and midazolam. Methods: A total number of sixty patients ASA grade I&II were selected randomly as per inclusion & exclusion criteria in two groups. Thirty in each group. In group A, caudal block was given by bupivacainemidazolam mixture and in group B, caudal block was given by bupivacaine in lateral decubitus position, just after completion of surgery before reversed from GA. In post operative period arterial blood pressure, heart rate, and duration of analgesia were recorded. Results: There was no significant difference between the groups of blood pressure, heart rate, and pain score up to 30 min but after one hour of post operative period pain scores were significant(p<0.05). Conclusion: Midazolam improves the duration and quality of analgesic effect of bupivacaine. DOI: http://dx.doi.org/10.3329/jbsa.v23i1.18152 Journal of BSA, 2010; 23(1): 8-13

scholarly journals Effect of acupuncture TENS versus conventional TENS on post cesarean section incision pain

2018 ◽  
Vol 7 (9) ◽  
pp. 3738
Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Control Group ◽  
P Value ◽  
Random Allocation ◽  
Lower Segment Caesarean Section ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.

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