Postoperative Analgesia in Paediatrics Patients Through Caudal Block With Bupivacaine and Two Different Doses of Fentanyl - A Comparative Study.

Acharya, Ranjita; Jena, Saubhagya Kumar; Samal, Soumya; Mishra, Suvendu Narayan

doi:10.14260/jemds/1341

Cited by 5 publications

(10 citation statements)

References 8 publications

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“…It produces minimal hemodynamic changes and provides some pain-free period intraoperatively and postoperatively in infraumbilical surgeries in children. [ 1 2 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…Various adjuvant drugs such as ketamine, midazolam, tramadol, fentanyl, clonidine, dexmedetomidine have been used to prolong the duration of analgesia for the caudal block. [ 1 10 ]…”

Section: Discussionmentioning

confidence: 99%

“…It easily crosses the lumbar dura and penetrates quickly the lipid phase of the underlying tissue of the cord with minimal migration of opioids in rostral direction, hence, avoiding central nervous system depression of respiratory and cardiovascular system. [ 1 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative analgesia through the caudal epidural route with bupivacaine in children is firmly established in infraumbilical surgery. [ 1 2 ] The mean duration of surgical analgesia provided by bupivacaine is limited. [ 3 ] Different drugs such as tramadol, fentanyl, clonidine, and midazolam with bupivacaine prolong the postoperative analgesia.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of caudal tramadol versus caudal fentanyl with bupivacaine for prolongation of postoperative analgesia in pediatric patients

Solanki

Jansari

2016

Saudi J Anaesth

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Background and Aims:Caudal block is a common technique for pediatric analgesia for infraumblical surgeries. Because of the short duration of analgesia with bupivacaine alone various additive have been used to prolong the action of bupivacaine. The present study was aimed to evaluate the analgesic effect of tramadol or fentanyl added to bupivacaine for infraumblical surgeries in pediatric patients.Materials and Methods:We conducted a prospective, randomized, single-blind controlled trial. After written informed consent from parents, 100 patients belonging to American Society of Anesthesiologist physical status I-II, in the age group of 1-12 years, of either sex undergoing infraumblical surgery under general anesthesia were divided into two groups. Group BT received 1 ml/kg of 0.25% bupivacaine with tramadol 2 mg/kg in normal saline and Group BF received 1 ml/kg of 0.25% bupivacaine with fentanyl 2 μg/kg in normal saline with maximum volume of 12 ml in both groups. All patients were assessed intraoperatively for hemodynamic changes, the requirement of sevoflurane concentration, as well as postoperatively for pain by using FLACC (F = Face, L = Leg, A = Activity, C = Cry, C = Consolability), pain score and for sedation by using four point sedation score.Results:The mean duration of analgesia was 10–18 h in Group BT while in Group BF it was 7-11 h. The postoperatively period up to 1½ h, Group BF had higher sedation score up to two as compared to that below one on Group BT.Conclusion:Caudal tramadol significantly prolongs the duration of analgesia as compared to caudal fentanyl without any side effects.

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“…It produces minimal hemodynamic changes and provides some pain-free period intraoperatively and postoperatively in infraumbilical surgeries in children. [ 1 2 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…Various adjuvant drugs such as ketamine, midazolam, tramadol, fentanyl, clonidine, dexmedetomidine have been used to prolong the duration of analgesia for the caudal block. [ 1 10 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of caudal tramadol versus caudal fentanyl with bupivacaine for prolongation of postoperative analgesia in pediatric patients

Solanki

Jansari

2016

Saudi J Anaesth

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“…Ranjita A et al [32] concluded that caudal fentanyl at dose of 1 μg/kg-1 produces longer post-operative analgesia as compared to the dose of 0.5 μg/kg-1 without any adverse effects.…”

Section: Discussionmentioning

confidence: 99%

A Randomised, Double-Blind, Prospective Study of Caudal Ropivacaine Versus Ropivacaine With Fentanyl Versus Ropivacaine With Neostigmine for Combined Epidural and General Anaesthesia in Children

Rao¹,

Babu²,

Patta³

2017

jemds

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BACKGROUNDThere are no studies comparing the outcomes of using Fentanyl or Neostigmine as adjuvants to Ropivacaine in terms of postoperative analgesia for paediatric caudal block. The aim of our study is to compare the outcomes of using Ropivacaine 0.2% vs Ropivacaine 0.2% with Neostigmine 2 mcg/kg vs Ropivacaine with Fentanyl 1 mcg/kg as a single shot caudal block on postoperative analgesic effect in children aged 3 -8 yrs. undergoing subumbilical surgeries. MATERIALS AND METHODSThis is a double-blind, randomised, controlled, prospective study. Our study included 60 paediatric patients undergoing elective lower abdominal surgeries at Rajiv Gandhi Institute of Medical Sciences, Srikakulam, Andhra Pradesh. RESULTSThe patient groups were comparable with respect to age and weight. The mean pain scores at 24 hrs. in R, RF and RN groups are 3.05 ± 0.6, 2 ± 0.5, 2.65 ± 0.67 respectively with a p-value of 0.008, which is statistically significant. The duration of analgesia in R, RF and RN groups are 383, 353 and 680.5 mins. respectively with a p-value of ˂ 0.05, which is statistically significant. CONCLUSIONWe conclude in the present study that the addition of neostigmine to caudal Ropivacaine resulted in prolongation of duration of analgesia, while a Ropivacaine and Fentanyl mixture did not cause any statistically significant increase in the duration of analgesia. KEYWORDSRopivacaine, Fentanyl, Neostigmine, Caudal Analgesia. HOW TO CITE THIS ARTICLE:Rao MP, Babu SP, Saroj P. A randomised, double-blind, prospective study of caudal ropivacaine versus ropivacaine with fentanyl versus ropivacaine with neostigmine for combined epidural and general anaesthesia in children. J. Evolution Med. Dent. Sci. 2017;6(44):3459-3468, DOI: 10.14260/Jemds/2017/748 BACKGROUND Pain is "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage" as defined by the International Association for the Study of Pain. [1] Pain is always subjective.In children even the definition of pain has been debated. [2] The structural components necessary to perceive pain are already present at about 25 weeks gestation, whereas the endogenous descending inhibitory pathways are not fully developed until mid-infancy. [3,4] It has been recognised for some time that the management of acute pain, especially post-operative pain, has been consistently inadequate. If anything, the situation in children has been even worse, who have long been undermedicated for acute pain. [5] The various drugs used for the treatment of acute postoperative pain are local anaesthetics (local/regional Financial or Other, Competing Interest: None. Submission 21-04-2017, Peer Review 19-05-2017, Acceptance 25-05-2017, Published 01-06-2017. Corresponding Author: Dr. Soumya Panickessery Babu, D/No. 39-6-72, Muralinagar, Visakhapatnam-530007. E-mail: pbsoums.k@gmail.com DOI: 10.14260/jemds/2017 analgesia), opioids, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and acetaminophen. The different availab...

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2018

JAICM

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Objective: To compare the effectiveness of caudal bupivacaine, bupivacaine plus fentanyl and bupivacaine plus tramadol for post operative analgesia in children. Materials and methods:The study was conducted on 75 children of ASA I and II physical status aged 1 to 12 years undergoing elective infraumbilical surgeries. Patients were divided into 3 groups and the following were given in the caudal epidural space after the induction of anesthesia: a) Group I: 0.125% Inj. Bupivacaine 1ml/kg b) Group II: 0.125 Inj. Bupivacaine 1ml/kg plus Inj. Fentanyl 1mcg/kg c) Group III: 0.125% Inj. Bupivacaine 1ml/kg plus Inj. Tramadol 2mg/kg Results: Group III had a lower pain score, prolonged mean duration of analgesia, less requirement for rescue analgesics compared to the other two groups. Conclusion:Addition of Tramadol to Bupivacaine provides prolonged and good quality post operative analgesia in comparison with Bupivacaine alone or with Fentanyl in Caudal Block in the post operative period.

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Postoperative Analgesia in Paediatrics Patients Through Caudal Block With Bupivacaine and Two Different Doses of Fentanyl - A Comparative Study.

Cited by 5 publications

References 8 publications

Comparison of caudal tramadol versus caudal fentanyl with bupivacaine for prolongation of postoperative analgesia in pediatric patients

Comparison of caudal tramadol versus caudal fentanyl with bupivacaine for prolongation of postoperative analgesia in pediatric patients

A Randomised, Double-Blind, Prospective Study of Caudal Ropivacaine Versus Ropivacaine With Fentanyl Versus Ropivacaine With Neostigmine for Combined Epidural and General Anaesthesia in Children

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