Objective: Comparison was done between the post operative analgesia provided by caudal Ketorolac versus Caudal Lignocaine after perineal surgeries like haemorrhoidectomy, anal fissurectomy, anal fistulectomy, excision of pilonidal sinus, correction of hypospadias and epispadias.
Methods: This study was conducted at the Anaesthesiology department IIMC-T, Railway Hospital, Rawalpindi, Pakistan over a period of 6 months. A total of 50 patients undergoing perineal surgeries were studied by conventional sampling. Patients underwent perineal surgeries under general anaesthesia. These patients were given injection Nalbuphine 10 mg I/V preoperatively. Surgery was conducted under general anesthesia and at the end of surgery, they were divided into two study groups; A&B. Group A comprised of 25 patients who were given injection Lignocaine 1% through caudal block. Group B also comprised of 25 patients, who were given injection Ketorolac 10 mg through caudal route. Pain relief was assessed by using Visual Analogue Scale (VAS) in the post anesthesia care unit (PACU)/recovery room.
Results: It was observed that caudal Lignocaine in group A provided analgesia quickly within 3 ± 1 minutes and duration of action varied from 2 4 hours. In group B patients injected with Ketorolac, the onset of action was 10±5 minutes. Duration of action varied from 1 3 hours. Pain relief was also better with Lignocaine 1% i.e. 80% in surgeries. Regarding Ketorolac, percentage pain relief was 50 60%.
Conclusions: This study shows that caudal Lignocaine provides better analgesia, with fewer side effects and it is more economical as compared to Ketorolac since need of adjuvant pain killers was less frequent in this group. Early mobilization of patients, and discharge from hospital, was seen in Ketorolac group which required frequent adjuvant drugs i.e. injection Nalbuphine adding to the cost of treatment.
Key words: Postoperative analgesia, perineal surgery, caudal block, Ketorolac, Lignocaine.
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