scholarly journals Role of Different Volumes and Dilutions of Intraperitoneal Lignocaine Instillation on Postoperative Morbidity Following Laparoscopic Cholecystectomy : A Randomised Control Trial

2020 ◽  
Author(s):  
Varun Kumar Singh ◽  
Sofia Batool ◽  
Babita Chettri ◽  
Kumar Nishant ◽  
Wali Ahmad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Respiratory Rate ◽  
Normal Saline ◽  
Nausea And Vomiting ◽  
Time Intervals ◽  
Rescue Analgesia ◽  
Postoperative Time ◽  
Group A ◽  
Group B

Introduction: Even though Laparoscopic Cholecystectomy (LC) is far less traumatic compared to open cholecystectomy, it is still associated with considerable postoperative pain. Apart from routine analgesics, several attempts have been made to establish intraperitoneal analgesia as a useful perioperative pain relief modality. Aim: To determine the optimal concentration (or dilution) and volume of intraperitoneal lignocaine among three preparations of 100 mg lignocaine for postoperative analgesia after LC. Materials and Methods: Study was designed as a randomised controlled, double blinded study. Patients undergoing elective LC for symptomatic cholelithiasis were included in the study. Patients (n=105) were randomised into three groups. Group A received 5 mL 2% lignocaine in 5 mL normal saline (100 mg/10 mL=10 mL solution of 1% lignocaine). Group B received 5 mL 2% lignocaine in 100 mL of normal saline (100 mg/100 mL=100 mL solution of 0.1% lignocaine). Group C received 5 mL 2% lignocaine in 500 mL normal saline (100 mg/500 mL=500 mL solution of 0.02% lignocaine). Three groups were compared for postoperative pain using Visual Analog Score (VAS), requirement of rescue analgesia, nausea and vomiting, vital parameters (heart rate, respiratory rate, mean arterial pressure, transcutaneous saturation) and hospital stay. Analysis of Variance (ANOVA) was used to compare mean and χ2 test was used to compare categorical data. Results: The mean VAS of group B (100 mg lignocaine in 100 mL of normal saline) was significantly lower than the overall mean VAS at different postoperative time intervals, and consistently lower than those of groups A and C. The study found a consistent (r=0.15 to 0.33) and significant (p<0.05 at all-time intervals) positive correlation between pain and duration of surgery. Demand for rescue analgesia was significantly higher in group A. Pulse rate was least in all postoperative time and significantly lower at 4th hour. The difference in mean arterial pressures, respiratory rate and transcutaneous saturation among the three groups was not significant statistically. Nausea and vomiting were uncommon. Conclusion: The study concluded that for a total dose of 100 mg lignocaine, 100 mL solution is more effective compared to 10 mL or 500 mL solution.

scholarly journals Comparison of intraincisional and intraperitoneal infiltration of local anaesthetic in laparoscopic cholecystectomy to control early postoperative pain.

2021 ◽  
Vol 28 (02) ◽  
pp. 192-196
Author(s):  
Nadia Bano ◽  
Nazim Hayat ◽  
Saira Saleem ◽  
Farhan Javaid ◽  
Ayesha Rehman ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Local Anaesthetic ◽  
Early Postoperative Period ◽  
P Value ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B

Objective: To compare the effects of intraincisional and intraperitoneal infiltration of local anaesthetic to relieve early postoperative pain in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Department of Anaesthesia and Surgery, Madinah Teaching Hospital Faisalabad. Period: July 2017 to March 2018. Material & Methods: A sample of 100 patients with American Society of Anaesthesiologists Physical status (ASA) I and II, undergoing laparoscopic cholecystectomy were selected using simple random sampling technique. Patients were randomly assigned into groups A and B. Group A patients received intraperitoneal infiltration of 20 ml solution of 0.25% bupivacaine and group B patients received intraincisional infiltration of 20 ml solution of 0.25% bupivacaine. Results:  Demographic characteristics were not significantly different in both groups. Our study showed that Group A patients had better pain relief as compared to group B patients. Visual analogue score (VAS) for pain relief at 0, 3,6,12 and 24 hours was statistically different in both groups. The requirement of rescue analgesia between group A and B was found to be12% and 38% which is statically significant (p value 0.003). Conclusion: intraperitoneal infiltration of Bupivacaine offers better postoperative pain relief after laparoscopic cholecystectomy and is associated with less analgesic requirement in early postoperative period.

scholarly journals The new trending pain-free cesarean section: TAP block versus IV PCA

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Sondos M. Salem ◽  
Mazen Abdel-Rasheed ◽  
Mohammad A. Gouda ◽  
Sameh Salama
Keyword(s):  
Heart Rate ◽  
Postoperative Pain ◽  
Cesarean Section ◽  
Respiratory Rate ◽  
Intestinal Motility ◽  
Nausea And Vomiting ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Group A ◽  
Group B

Abstract Background Women's pain satisfaction post-cesarean section remains a challenge. Accurate assessment of pain severity of post-cesarean section helps to choose the most appropriate anesthetic approach, drug, and dose, as well as improvement of treatment of postoperative pain. Our objective was to compare the efficacy of ultrasound-assisted transversus abdominis plane (TAP) block versus IV patient-controlled analgesia (PCA) in the first 24 h postoperative in women who underwent cesarean section. The primary outcome was postoperative pain at 2, 4, 6, 12, and 24 h. The secondary outcomes were intestinal mobility, early mobilization, nausea, vomiting, heart rate, and respiratory rate. Results A cross-sectional study has been conducted on 70 women who are planned for elective cesarean section. They were divided into 2 groups; “group A” (n = 35), women who received TAP block, and “group B” (n = 35), those who received PCA. Pain score, heart rate, respiratory rate, intestinal motility, nausea, and vomiting have been assessed 2, 4, 6, 12, and 24 h postoperatively. The degree of pain was significantly lower in “group B” than in “group A” in all time intervals (p < 0.001). Heart rate was significantly higher in women in “group B” compared to those in “group A” only at 2 and 4 h postoperative (p < 0.001). Nausea and vomiting were also significantly higher in women in “group B” compared to those in “group A” (p value 0.03 and 0.04, respectively). Regarding intestinal motility, it was audible in “group A” earlier than in “group B.” Conclusions Both TAP block and PCA are effective in postoperative pain relief after cesarean section; however, PCA is more superior, especially for visceral pain. Nevertheless, TAP block has the privilege of avoiding systemic action of opioids used in PCA. PCA can easily be applied while TAP block needs more training and an intraoperative ultrasound machine. Complications and side effects of both were minimal when adjusting the doses.

scholarly journals Post operative nausea and vomiting after laparoscopic cholecystectomy: comparison of prophylactic effect of dexamethasone with ondansetron

2014 ◽  
Vol 24 (2) ◽  
pp. 60-64
Author(s):  
M Younus Ali ◽  
Raihan Uddin ◽  
Amirul Islam ◽  
Mustafa Kamal ◽  
SM Rafiqul Islam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Vital Signs ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Group A ◽  
The Difference ◽  
Prophylactic Use ◽  
Group B ◽  
Post Operative Nausea

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy under general anaesthesia are an unpleasant,distressing effects. Prophylactic use of dexamethesone reducing this effects. Objective This study was designed to compare of dexamethasone and ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholesystectomy were randomly allocated into two groups. Group A(n=30) patients received 8mg dexamehtasone intravenously and Group B(n=30) patients received 8mg ondansetron intravenously one minute before induction of anaesthesia. All patients received standard general anaesthesia.Perioperative vital signs and postoperative nausea and vomiting were recorded. Results The incidence of nausea was 13.4% in group A, 16.7% in group B(p>0.05) and vomiting was 6.6% in Group A, 13.4% in group B(p>0.05). The difference among the groups was not statistically significant. Conclusion Intravenous dexamethasone was better to ondansetron in prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19803 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 60-64

scholarly journals Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

2016 ◽  
Vol 3 (2) ◽  
pp. 41 ◽  
Author(s):  
Mahesh Sharma ◽  
Kalpana Kharbuja ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Normal Saline ◽  
Randomized Study ◽  
Saline Group ◽  
Normal Saline Group ◽  
Analgesic Requirement ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy.  Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy.   Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19.   Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable.   Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Analgesic Requirement ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

scholarly journals Comparison of Pre-emptive Use of Diclofenac, Ketorolac and Tramadol for Post-operative Pain in Laparoscopic Cholecystectomy

2009 ◽  
Vol 20 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Md Rafiqul Hasan Khan ◽  
Md Zohirul Islam ◽  
Md Sazzad Hossain ◽  
Lutful Aziz ◽  
SN Samad Choudhury
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Analgesic Efficacy ◽  
Prospective Clinical Study ◽  
The Poor ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Better Than

Under treatment of postoperative pain has been the topic of several recent editorials. The prevention, recognition, and management of postoperative pain in adults, as well as in children, have been receiving a great deal of interest. The poor outcome obtained with current regimens is primarily due to the inadequacies of drug administration techniques rather than the qualities of opioids themselves. In this prospective study comparison of preemptive use of diclofenac, ketorolac and tramadol was done for postoperative pain in laparoscopic cholecystectomy. 60 patients were divided into three groups. Group A received injection Diclofenac (3mg/kg) 75mg maximum at a time. Group B received injection Ketorolac (30 mg). And group C patients received injection Tramadol (100 mg). All drugs were given intravenous half an hour before induction. Analgesic efficacy was measured in VAS scale. In addition pulse, systolic blood pressure, diastolic blood pressure, mean blood pressure, total pethidine requirement and time of first pethidine requirement were recorded Patients received an increment of 10-20 mg of pethidine when pain score was 3-4. In this study, total pethidine consumption in group A is 56.5±5.14, in group B is 46.75±4.65 and in group C is 49±5.42. It shows that group B and group C have same analgesic effectiveness and which is better than group A. On the basis of present prospective clinical study postoperative pain can be managed by preemptive use of diclofenac, ketorolac and tramadol. The analgesic efficacy of ketorolac and tramadol is same and better than diclofenac. Key Words: Pre-emptive analgesia, Laparoscopic cholecystectomy. Journal of BSA, Vol. 20, No. 1, January 2007 p.24-29

scholarly journals CHOLECYSTECTOMY;

2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Patient Population ◽  
P Value ◽  
Care Hospital ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Eye Opening ◽  
Group B

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.

scholarly journals Hyperglycemic Response of Non-diabetic Women Undergoing Abdominal Hysterectomy Who Have Received Prophylactic Dexamethasone to Alleviate Nausea and Vomiting

2020 ◽  
Author(s):  
Saghar Samimi Sadeh ◽  
Ehsan Bastanhagh ◽  
Somayeh Mohammadi ◽  
Reza Shariat Moharari ◽  
Pejman Pourfakhr ◽  
...  
Keyword(s):  
Normal Saline ◽  
Abdominal Hysterectomy ◽  
Nausea And Vomiting ◽  
Diabetic Patients ◽  
Anesthetic Induction ◽  
Double Blind ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Background: This study has been designed to assess the hyperglycemic response in non-diabetic patients in women undergoing abdominal hysterectomy; who have received a prophylactic dose of dexamethasone to alleviate post-operative nausea and vomiting (PONV). Methods: This was a double blind randomized clinical trial involving seventy women who were candidates for abdominal hysterectomy. The women were randomly assigned into two groups. Group A received 8mgs (in 50 mls normal saline) of IV dexamethasone; post-anesthetic induction and pre-surgery. Group B received 50 mls of normal saline post-anesthetic induction and pre-surgery. Patients were asked whether they had any nausea and vomiting during recovery. The patients’ blood sugar (BS) levels were assessed before surgery, during recovery and then 1, 6, 12, 18, and 24 hours after surgery. Results: Thirty-three women in each group were monitored. Assessment of the results indicates that nausea and vomiting were not significantly different between the two groups. The age and BS before surgery of the patients were not significantly different. BS levels after surgery were significantly higher for the group receiving dexamethasone; with the exception of the levels during the first hour. Conclusion: The BS of women undergoing abdominal hysterectomy is significantly higher for those receiving a single dose of dexamethasone, post-operatively, compared to patients receiving a placebo. The finding of this study does not support the role of dexamethasone in the prophylactic anti-emetic treatment in abdominal hysterectomy.

scholarly journals Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
P Value ◽  
Chi Square ◽  
Vas Score ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Operative Evaluation ◽  
Group A ◽  
Group B

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.

scholarly journals CAUDAL ANALGESIA IN CHILDREN;

2012 ◽  
Vol 19 (05) ◽  
pp. 715-718
Author(s):  
MUHAMMAD AMER ◽  
MUHAMMAD SAIF UL MALOOK ◽  
MUHAMMAD SHER UZ ZAMAN
Keyword(s):  
Postoperative Period ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Nausea And Vomiting ◽  
Single Shot ◽  
Rescue Analgesia ◽  
Caudal Analgesia ◽  
Group A ◽  
Analgesic Technique ◽  
Group B

Background: Caudal analgesia with bupivacaine is used commonly for pain relief in children and extradural administration oftramadol seems to be a safe method of analgesia. The aim of the study was to compare the analgesic efficacy of caudal bupivacaine andbupivacaine and tramadol mixture for postoperative analgesia and to observe for the side effects. Setting: Department of Anesthesia andIntensive Care Unit, Bahawal Victoria Hospital, Bahawalpur. Period: 01-12-2010 to 30-11-2011. Methods: Eighty children, aged between 2 to12 years of age undergoing infra umbilical surgeries were selected for this randomized, controlled trial. They were randomly divided into twogroups A and B. Group A (n = 40) received 0.5 ml/kg of 0.25 % bupivacaine and Group B (n = 40) received 0.5 ml/kg of 0.25 % bupivacaine with 1mg/kg of tramadol as a single shot caudal block. In the postoperative period, duration of analgesia, pain score, nausea, vomiting and sideeffects were noted and analyzed. Results: Patients in both groups were comparable for age and weight. It was observed that the meanduration of analgesia in group A patients was 6.23+0.68 hours while in group B, it was 9.33+0.72 hours (p<0.05). Nausea and vomiting waspresent in 20% (n=8) patients in group A, while in group B, 27.5% (n=11) had nausea and vomiting in the post operative period (p<0.05). None ofthe patients in both the groups had complications like motor weakness, urinary retention in the postoperative period. Conclusions: Theaddition of tramadol to bupivacaine in the caudal analgesic technique provides longer analgesia and lesser need for rescue analgesia in thepostoperative period compared to bupivacaine alone.

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