Caudal epidural analgesia in pediatric patients: Comparison of 0.25% levobupivacaine and 0.25% ropivacaine in terms of motor blockade and postoperative analgesia

Background: This study was conducted to compare and evaluate the caudal epidural clonidine when mixed with ropivacaine and bupivacaine in prolonging postoperative analgesia in children of Indian genotype undergoing hypospadias surgery, as well as compare the intraoperative haemodynamics using caudal bupivacaine with clonidine vs ropivacaine with clonidine. The study was also aimed at studying the side effects and the duration of post-operative pain relief of bupivacaine with clonidine v/s ropivacaine with clonidine. Methods: This is a prospective randomised comparative study that was carried out in the Department of Anaesthesiology, KEM Hospital, Pune, over 12 months (from October 2016 to September 2017), among 56 children having an ASA Grade of II, aged between 1 to 8 years admitted for hypospadias surgery. The data gathered was cleaned using Microsoft Excel, before statistical analysis was done. Results: It was observed that caudal epidural analgesic duration was more in the bupivacaine clonidine group than in the ropivacaine clonidine group. The sedation score was higher at the second hour in the bupivacaine clonidine group. The HR and mean arterial pressure values were found to be notably higher in the ropivacaine clonidine group than those in the bupivacaine clonidine group. Intraoperatively and postoperatively, there was a decrease in pulse rate and MAP but at no time did the value reach the criteria for intervention. Other side effects like postoperative vomiting, nausea, motor blockade, respiratory distress not observed in any group. Conclusion: Bupivacaine 0.25 % 0.5 ml per kg with clonidine 1 microgram / kg via caudal route increased the duration of postoperative analgesia with no adverse effects as compared to ropivacaine 0.25 % with clonidine 1 microgram/ kg. Hence clonidine is more efficient in increasing postoperative analgesia when added with Bupivacaine as compared to ropivacaine in Indian genotype in hypospadias surgery.

Download Full-text

The Effect of Continuous Epidural Analgesia on Intracranial Pressure by Measuring the Optic Nerve Sheath Diameter Using Ultrasound in Pediatric Patients

Case Medical Research ◽

10.31525/ct1-nct03911804 ◽

2019 ◽

Author(s):

Keyword(s):

Optic Nerve ◽

Intracranial Pressure ◽

Epidural Analgesia ◽

Pediatric Patients ◽

Optic Nerve Sheath Diameter ◽

Optic Nerve Sheath ◽

Nerve Sheath ◽

Continuous Epidural Analgesia

Download Full-text

Faculty Opinions recommendation of Parent-assisted or nurse-assisted epidural analgesia: is this feasible in pediatric patients?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1284003.751113 ◽

2009 ◽

Author(s):

Giorgio Ivani ◽

Valeria Mossetti

Keyword(s):

Epidural Analgesia ◽

Pediatric Patients

Download Full-text

A comparison of parecoxib and thoracic epidural analgesia for postoperative analgesia following Nuss procedure

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2015.08.020 ◽

2015 ◽

Vol 50 (12) ◽

pp. 2032-2034 ◽

Cited By ~ 3

Author(s):

Wendy Yang ◽

Yung-Ching Ming ◽

Yi-Chuan Kau ◽

Chia-Chih Liao ◽

Shih-Chang Tsai ◽

...

Keyword(s):

Epidural Analgesia ◽

Postoperative Analgesia ◽

Thoracic Epidural Analgesia ◽

Nuss Procedure ◽

Thoracic Epidural

Download Full-text

Motor blockade is reduced with ropivacaine 0.125% for parturient-controlled epidural analgesia during labour

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/bf03013195 ◽

1999 ◽

Vol 46 (11) ◽

pp. 1019-1023 ◽

Cited By ~ 21

Author(s):

Alex Tiong-Heng Sia ◽

Poopalalingam Ruban ◽

Jin Long Chong ◽

Kahoe Wong

Keyword(s):

Epidural Analgesia ◽

Motor Blockade

Download Full-text

Comparison of lidocaine, xylazine, and lidocaine−xylazine for caudal epidural analgesia in cattle

Veterinary Anaesthesia and Analgesia ◽

10.1046/j.1467-2995.2001.00068.x ◽

2002 ◽

Vol 29 (2) ◽

pp. 64-68 ◽

Cited By ~ 27

Author(s):

Tamara L Grubb ◽

Thomas W Riebold ◽

Russell O Crisman ◽

L Dean Lamb

Keyword(s):

Epidural Analgesia ◽

Caudal Epidural

Download Full-text

Comparative Study Between Caudal Block And Local Wound Infiltration In Inguinal Hernia Repair In Pediatric Patients

QJM ◽

10.1093/qjmed/hcab086.108 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Azza Mohamed Shafeek Abdel Mageed ◽

Wael Reda Hussaein ◽

Rania Hassan Abdel Hafiez ◽

Tarek Atef Abdullah Hammouda

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Pain Score ◽

Inguinal Hernia Repair ◽

Postoperative Analgesia ◽

Pediatric Patients ◽

Caudal Block ◽

Wound Infiltration ◽

Unilateral Inguinal Hernia ◽

Significant Difference

Abstract Background Postoperative analgesia can be provided by a multimodal approach includes opioids, nonsteroidal anti-inflammatory drugs, paracetamol infusion and regional anesthetic techniques such as local infiltration or nerve blocks. In contrast to opioids, local anesthetics can be administered safely and in recent guidelines regional anesthesia is accepted as the cornerstone of postoperative pain relief in the pediatric patients. Objective Compare the postoperative analgesic effectiveness of local wound infiltration of bupivacaine against bupivacaine administered caudally in pediatric patients undergoing unilateral inguinal hernia repair. Patients and methods This study was carried out in Ain Shams University hospitals on 40 pediatric patients of both sexes aged from 6 months to 7 years belonging to ASA I or II undergoing elective unilateral inguinal hernia repair. They were randomly allocated into two groups: group C receiving caudal block, group L receiving local wound infiltration. Hemodynamic changes, postoperative pain score using FLACC pain score, postoperative analgesia and complications were recorded. Results There was no significant difference between the two groups as regard demographic data or hemodynamic variables. Pain score shows no statically significant differences between two groups in the first hour. But statistically significant decrease in FLACC score after (1, 2 and 3 hours) in group C in comparison with group L.decreased significantly in group C after 1 hour postoperative. Duration of analgesia longer in group C with no significant difference in total amount of postoperative analgesia. There was significant increase in incidence in complications in group C than group L Conclusion Caudal block provides better and longer analgesia but requires experience and may lead to complications. In contrast, wound infiltration is simple without significant side effects. Therefore, local wound infiltration may be a preferred technique for producing postoperative analgesia in pediatric inguinal hernia repair.

Download Full-text

Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries

Research & Innovation in Anesthesia ◽

10.5005/jp-journals-10049-0010 ◽

2016 ◽

Vol 1 (2) ◽

pp. 35-40 ◽

Cited By ~ 2

Author(s):

Naina P Dalvi ◽

Narendra Patil

Keyword(s):

Blood Pressure ◽

Postoperative Analgesia ◽

Total Duration ◽

Double Blind Study ◽

Motor Blockade ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Sensory Blockade ◽

Prolonged Duration ◽

American Society

ABSTRACT Introduction This single-center, prospective, randomized, double-blind study compares the effect of intrathecal fentanylbupivacaine and tramadol-bupivacaine on the onset and duration of sensory and motor blockade, as well as postoperative analgesia in lower abdominal surgeries. Materials and methods Patients of either sex, aged 18 to 60 years, American Society of Anesthesiologists (ASA) grade I/II undergoing lower abdominal surgeries like appendicectomy, inguinal hernia repair surgery, and hydrocele surgery were administered either 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 μg) of fentanyl citrate (group F) or 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 mg) of tramadol (group T) intrathecally. Monitoring of the vital parameters, onset and duration of sensory and motor block, duration of postoperative analgesia, visual analog scale (VAS) score, sedation score, and any adverse drug reactions was done at predetermined intervals. Results Sixty patients were randomized to the group F (n = 30) and group T (n = 30). The duration of sensory blockade was significantly prolonged in group F (314.66 ± 49.25 minutes) as compared to group T (261.66 ± 27.92 minutes). Similarly, duration of motor blockade was longer in group F (263.66 ± 40.97 minutes) compared to group T (214.66 ± 26.61 minutes). The total duration of analgesia was significantly prolonged (p < 0.001) in group F (412 ± 97.888 minutes) compared to group T (301 ± 38.75 minutes). Hemodynamic parameters, such as pulse, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups. Visual analog scores were significantly lower in the group F patients as compared to the group T patients. The group F patients had got significantly higher sedation scores as compared to Group T patients. Discussion Fentanyl 25 μg, when added to 2.5 mL of 0.5% hyperbaric bupivacaine, confers prolonged duration of sensory and motor blockade than 25 mg tramadol added to 2.5 mL of 0.5% hyperbaric bupivacaine. The bupivacaine-fentanyl combination prolonged duration of sensory and motor blockade, improved analgesia, as manifested by lower pain scores, and prolonged duration of postoperative analgesia. How to cite this article Dalvi NP, Patil N. Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries. Res Inno in Anesth 2016;1(2):35-40.

Download Full-text