Caudal epidural butorphanol plus bupivacaine versus bupivacaine in pediatric outpatient genitourinary procedures

Lawhorn, C. David; Stoner, Jo Anne M.; Schmitz, Michael L.; Brown, Raeford E.; Stewart, Frank W.; Volpe, Paula; Shirey, Robert

doi:10.1016/s0952-8180(97)00231-6

Cited by 17 publications

(5 citation statements)

References 20 publications

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“…Singh V et al concluded that need for rescue analgesia in PACU and total numbers of doses of morphine administered were significantly less in patients in whom butorphanol was added to bupivacaine in caudal epidural analgesia. 8 In our study, the variation in the heart rate, blood pressure, respiratory rate and SpO2 was comparable in all the three groups in both the intraoperative and the postoperative periods and this was not statistically significant. This implies that addition of butorphanol/clonidine to bupivacaine did not produce any significant effect on haemodynamics.…”

Section: Resultsmentioning

confidence: 43%

“…This implies that addition of butorphanol/clonidine to bupivacaine did not produce any significant effect on haemodynamics. 8,9 Martin et al carried out a study and found that with caudal anaesthesia the most common side effect is urinary retention. 15 In our study 4% patients in Group A, 8% patients in Group B and 4% patients in Group C had urinary retention.…”

Section: Resultsmentioning

confidence: 99%

“…5,6 Another study compared caudal bupivacaine-clonidine mixture with plain bupivacaine and concluded that addition of clonidine to bupivacaine improve the efficacy of caudal anaesthesia along with prolonged sedation in children 7 . Lawhorn C D et al in 1997 added butorphanol to bupivacaine for caudal analgesia and found an increase in the duration of analgesia 8 .…”

Section: Introductionmentioning

confidence: 99%

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Comparative Evaluation of Efficacy of Caudal Bupivacaine Alone or in Combination With Butorphanol or Clonidine for Postoperative Analgesia in Children

Chatrath¹,

Kaur²,

Attri³

et al. 2012

jemds

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BACKGROUND: Addition of adjuvant in caudal block along with bupivacaine prolongs the duration of postoperative analgesia. AIMS: The aim of this study was to evaluate the efficacy of caudal bupivacaine alone or in combination with butorphanol or clonidine for postoperative analgesia in children undergoing infra-umbilical surgeries. MATERIAL AND METHODS: This study was a prospective, randomized, double blind study and seventy five children of ASA grade I and II of either sex aged 3-8yr were randomized to one of the three groups. Group A received 1 ml/kg of 0.25% bupivacaine; Group B received 20 µg/kg of butorphanol in combination with 1 ml/kg of 0.25% bupivacaine; and Group C received 2 µg/kg of clonidine in combination with 1 ml/kg of 0.25% bupivacaine caudally after general anaesthesia was induced. Hemodynamic variables (HR, SpO2, RR and NIBP) were monitored in all patients. Sedation score, mean duration of analgesia, modified objective pain score and requirement of rescue analgesia were recorded at preset time intervals along with various complications like nausea, vomiting, hypotension, bradycardia, respiratory depression, retention of urine, sweating, pruritis, hallucinations. STATISTYICAL ANALYSIS: ANOVA test (Analysis of variance) for intergroup comparison with parametric data, Student's paired t test for intragroup comparison, chi square test for non parametric data and complications and coefficient of variation for variation of parameters from the baseline. RESULTS: Mean duration of analgesia was maximum in group B (822.0±217.41 min) than in group A (383.2±81.04 min) and group C (745.4± 216.69 min) and it was statistically significant. The longer duration of sedation observed in group C was also statistically significant. No significant difference was observed in incidence of hemodynamic changes or side effects. CONCLUSION: Our results concluded that the addition of butorphanol and clonidine to bupivacaine resulted in superior analgesia with a longer duration of analgesia as compared to caudal bupivacaine alone. Moreover, addition of clonidine to bupivacaine resulted in a higher sedation score which is desirable in children.

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Section: Resultsmentioning

confidence: 43%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative Evaluation of Efficacy of Caudal Bupivacaine Alone or in Combination With Butorphanol or Clonidine for Postoperative Analgesia in Children

Chatrath¹,

Kaur²,

Attri³

et al. 2012

jemds

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“…The use of different local anaesthetics (Lignocaine, Mepivacaine, Bupivacaine or Ropivacaine) and the addition of caudal adjuvant (e.g. Adrenaline, Clonidine, Ketamine, Neostigmine, narcotics or alkalization with sodium bicarbonate) (16)(17)(18)(19)(20)(21)(22) must be evaluated for their efficacy and drug effects. All of these factors affect the level of analgesia, onset of action and duration of sensory and/or motor blockade.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Caudal Epidural Block for Minor Gynaecological Procedures in Day Care Surgery

Gayen¹,

Sarkar²

2019

jemds

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BACKGROUND It is a well-known fact that caudal epidural block is effective in delivering paediatric analgesia, but the data regarding its usefulness for sacral analgesia and anaesthesia in adult patients is scarce. In this study, it is applied in teenage and adult patients in obstetric and gynaecological minor surgical procedures. METHODS 179 female patients of ASA 1 and 2 of age group 11-70 yrs. undergoing minor gynaecological procedures were selected for this study. After pre anaesthetic checkup each patient was given 20 ml of 1.5% Lignocaine with Adrenaline (1:200000) in caudal epidural space. The effectiveness of caudal epidural block was studied in terms of type and duration of surgery, sensory level of analgesia, success rate, use of rescue analgesics and postoperative complications during PACU stay. RESULTS The result of this study is overwhelming. The success rate is 97.21%, only 5 patients required rescue analgesia with 2.79% failure rate. Average duration of anaesthesia and surgery were 36.4 mins and 22 mins respectively. Highest sensory level reached below T1W. Hypotension (6.14%), retention of urine (4.46%), persistent weak/heavy legs (3.91%), sedative requirement (10.05%),infection (1.11%) and sacral hematoma (0.55%) were among the side effects. 6.14% of patients had >2 hrs. stay at recovery. It was observed that caudal analgesia is effective for minor gynaecological and obstetric procedures with no significant failure rate, complications and no fatality. CONCLUSIONS Caudal epidural block is an alternate and simple procedure when compared to SAB/TIVA for MGP with high success rate and lesser side effects with decreased duration of PACU stay. Caudal epidural block is not only effective in paediatric patients but also in teens and adults for minor perineal procedures.

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“…Given butorphanol's sedative property, it is widely used in paediatric [11,17] and veterinary practice [18,19]; however, adult patients still need a minimum level of sedation in the earlier postsurgical period for reducing worry and anxiety from postoperative pain. Parker and colleagues [20,21] used a continuous infusion of morphine as a supplement to morphine PCA but did not find any improvement in pain relief compared with morphine PCA alone.…”

Section: Discussionmentioning

confidence: 99%

Continuous infusion of butorphanol combined with intravenous morphine patient-controlled analgesia after total abdominal hysterectomy: a randomized, double-blind controlled trial

Shen¹,

Liu²,

Xu³

et al. 2009

European Journal of Anaesthesiology

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Caudal epidural butorphanol plus bupivacaine versus bupivacaine in pediatric outpatient genitourinary procedures

Cited by 17 publications

References 20 publications

Comparative Evaluation of Efficacy of Caudal Bupivacaine Alone or in Combination With Butorphanol or Clonidine for Postoperative Analgesia in Children

Comparative Evaluation of Efficacy of Caudal Bupivacaine Alone or in Combination With Butorphanol or Clonidine for Postoperative Analgesia in Children

Effectiveness of Caudal Epidural Block for Minor Gynaecological Procedures in Day Care Surgery

Continuous infusion of butorphanol combined with intravenous morphine patient-controlled analgesia after total abdominal hysterectomy: a randomized, double-blind controlled trial

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