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

doi:10.22159/ajpcr.2023.v16i12.48734

Authors

AYUSHEE KHANDELWAL Department of Anesthesia, SMS Medical College, Jaipur, Rajasthan, India
RASHMI GUPTA Department of Anesthesia, SMS Medical College, Jaipur, Rajasthan, India
SURESH PANDEY Department of Anaesthesia, Jhalawar Medical College, Jhalawar,Rajasthan, India

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i12.48734

Keywords:

Caudal, Bupivacaine, Tramadol, Children, Infraumbilical surgeries

Abstract

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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