Comparison of Caudal Bupivacaine, Bupivacaine with Fentanyl and Bupivacaine with Tramadol Administration for Post Operative Analgesia in Children

Pavithra,

doi:10.19080/jaicm.2018.06.555681

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…In our study, nausea and vomiting were not present in any of the patients but reported in a study conducted by Khalid et al, [16] and Pavithra et al [17] may be due to the usage of increased dose of tramadol 2 mg/kg instead of 1 mg/kg as in our study.…”

Section: Discussionsupporting

confidence: 43%

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Comparative Clinical Evaluation of Caudal Bupivacaine Versus Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

AYUSHEE KHANDELWAL,

RASHMI GUPTA,

SURESH PANDEY

2023

Asian J Pharm Clin Res

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Objective: Effective post-operative pain management is crucial in pediatric patients undergoing infraumbilical surgeries. Various regional anesthesia techniques, including caudal block, have been used to provide post-operative analgesia in children. The addition of tramadol, a synthetic opioid analgesic, to bupivacaine in caudal anesthesia has shown potential benefits. This study aims to compare the clinical efficacy of single-shot caudal bupivacaine alone versus bupivacaine plus tramadol for post-operative analgesia in pediatric infra-umbilical surgeries. Methods: A prospective, randomized, double-blinded clinical study was conducted at our institute. The present study will be carried out in 60 pediatric patients of the American Society of Anesthesiologists Grades I and II between the age of 1 and 8 years, undergoing infraumbilical surgeries. These children were randomly divided into 2 groups. Group B (n=30) received caudal block with 0.25% bupivacaine (1 mL/kg) and Group BT (n=30) received caudal block with 0.25% bupivacaine (1 mL/kg) with tramadol (1 mg/kg). The variables studied were hemodynamic changes, duration of analgesia, and incidence of side effects. Pain assessment was done at 1, 2, 3, 4, 8, 12, and 24 h post-operatively using modified objective pain scale. Results: It was observed that the mean duration of analgesia in Group BT (9.05±2.21) h was significantly longer (p=0.0001) than Group B (3.78±0.94) h. Hemodynamic parameters remained comparable during intraoperative and post-operative periods. There was no incidence of nausea, vomiting, bradycardia, hypotension, pruritus, or decrease in respiratory rate in the two groups. Conclusion: In our study, we concluded that a single-shot caudal block with 0.25% bupivacaine (1 mL/kg) plus tramadol (1 mg/kg) resulted in longer duration of analgesia when compared to 0.25% bupivacaine (1 mL/kg) alone with no incidence of any side effects.

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Section: Discussionsupporting

confidence: 43%

“…(2018) [17] as single-shot caudal epidural using 1 mL/kg of 0.25% bupivacaine alone Group 1 and 2 μg/kg fentanyl Group 2 or with 2 mg/kg tramadol Group 3 in 1-12 years old undergoing elective infraumbilical surgeries. Onset of pain is seen between 8 and 12 h in Group 3 as against 4-8 h in the other groups.…”

Section: Discussionmentioning

confidence: 99%

Comparative Clinical Evaluation of Caudal Bupivacaine Versus Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

AYUSHEE KHANDELWAL,

RASHMI GUPTA,

SURESH PANDEY

2023

Asian J Pharm Clin Res

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“…V, Ramani M, Bysani P & Srinivas D. analyzed Caudal Bupivacaine, Bupivacaine with Fentanyl & Bupivacaine with Tramadol for Post Usable Absense of pain. They close expansion of Tramadol to Bupivacaine gives drawn out & great quality post employable absense of pain in examination with Bupivacaine alone or with Fentanyl in Caudal Block in the post usable period 20. This concentrate somewhat upholds our review.…”

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confidence: 56%

A comparative study between butorphanol and tramadol as adjuvant with epidural bupivacaine for post-operative analgesia after pelvi-acetabular surgery

Manuar,

Sofiullah,

Roy

et al. 2023

PJMS

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Epidural analgesia using local anaesthetic agent is popular simple, effective & economical way of providing postoperative analgesia. In few previous study opioids were added with local anaesthetics, so that even small doses can provide profound analgesia of longer duration with less side effects. We compared the efficacy of epidural butophanol with tramadol as adjuvant with bupivacaine, for postoperative analgesia in view of safety profile among opioids. Sixty patients undergoing pelvi-acetabular surgery were randomly assigned into two groups B & T in double blinded fashion. Group B received 2ml Butorphanol (2mg) & group T received 2ml of tramadol(100mg) as adjuvant with 8ml Bupivacaine (0.125%) as first does. 1ml Butorphanol (1mg) in group B & 1 ml Tramadol(50mg) in group T as adjuvant with 9ml Bupivacaine (0.125%) as subsequent does when VAS>4. Quality of analgesia assessed using VAS for 24hours. Duration of analgesia calculated by time of first analgesia request. Post-operative nausea vomiting & sedation compared. Both butorphanol group & tramadol group provide adequate analgesia but significantly lesser requirement of analgesic doses was observed in the group T compared to Group B. Duration of analgesia in Group B was about 6-7 hour & in Group T was about 8-9 hours. More PONV in Group T & more sedation in group B seen. Therefore, it suggests that epidural bupivacaine with butorphanol has better quality of analgesia in comparison with bupivacaine with tramadol. Although bupivacaine with tramadol has longer duration of analgesia but causes significant nausea & vomiting.

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“…2,3 There is plenty of literature regarding use of caudal epidural Bupivacaine for post-operative pain relief, but there is paucity of studies comparing Levo-Bupivacaine and Ropivacaine for pediatric caudal blocks. [7][8][9] Bupivacaine was introduced in 1963, is racemic mixture of R and S enantiomer, R-enantiomer of which is cardiotoxic. The drug also has neurotoxicity and residual motor block effects.…”

Section: Introductionmentioning

confidence: 99%

Comparison of post-operative analgesia with caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia

Hariharan,

Gupta,

Nagpal

et al. 2024

IJCA

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Post-operative pain relief following pediatric abdominal surgery is of paramount consideration and caudal block is still a popular, easy as well as safe analgesic technique for effective analgesia in children. With the advent of newer local anaesthetics, there has been a renewed interest in pediatric caudal blocks after lower abdominal surgeries following general anaesthesia. The aim of our study was to compare the efficacy and duration of postoperative analgesia using caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia.: The study was conducted on sixty, ASA grade 1, pediatric patients of age 2 to 6 years, of either sex, posted for elective infraumbilical surgery under general anaesthesia. They were randomly divided in two groups of 30 patients each. Group 1: - (n = 30) received caudal block with injection Ropivacaine, 0.25%, 1ml/kg. Group 2: - (n = 30) received caudal block with injection Levobupivacaine, 0.25%, 1ml/kg. Comparative, randomized, single blinded, observational study. : The demographic data was comparable in both the groups. Postoperatively, the quality of analgesia was assessed by the MOP (Modified Objective Pain Scale) score. Duration of postoperative analgesia was assessed by noting the time of giving rescue analgesia in the post-operative period. We also noted side effects, if any in both the groups. The quality of analgesia was found to be similar with both the drug groups (p value >0.05). The duration of analgesia was longer and statistically significant (p value = 0.0006) in the Ropivacaine group (8.43 ± 0.77 hours) as compared to the Levobupivacaine group (7.03 ± 2.03 hours). Statistically significant difference (P value = 0.026) was seen in the requirement rescue analgesia between Ropivacaine (3.33%) and Levobupivacaine (26.67%) groups. There were no major side effects in either of the groups, apart from a single patient out of 30 patients of Levobupivacaine group who had vomiting, compared with none in the Ropivacaine group.We conclude that caudal block with 0.25% Ropivacaine has a longer duration of action as compared to 0.25% Levobupivacaine in children undergoing infraumbilical surgery under general anaesthesia. Both Ropivacaine and Levobupivacaine, have similar quality of postoperative analgesia and side effect profile.

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Comparison of Caudal Bupivacaine, Bupivacaine with Fentanyl and Bupivacaine with Tramadol Administration for Post Operative Analgesia in Children

Cited by 3 publications

References 9 publications

Comparative Clinical Evaluation of Caudal Bupivacaine Versus Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

Comparative Clinical Evaluation of Caudal Bupivacaine Versus Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

A comparative study between butorphanol and tramadol as adjuvant with epidural bupivacaine for post-operative analgesia after pelvi-acetabular surgery

Comparison of post-operative analgesia with caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia

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