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Anaesth Pain & Intensive Care. 2019; 23(3): 279-283

A comparison of bupivacaine 0.25% with combination of tramadol-bupivacaine 0.25% via caudal epidural block for postoperative caudal analgesia and their side effects in children undergoing lower abdominal surgery under general anaesthesia

Noor Un Nisa, Saqib Butt, Hasham Khan, Ghulam Mustafa.

Background and aim:
Millions of children receive sedative, anaesthetic and analgesic drugs for surgery, worldwide. Caudal epidural block with bupivacaine is given as intra-operative as well as post operative analgesia in children undergoing surgeries under general anaesthesia. Current study aims to determine post-operative pain relief and side effects due to caudally administered 0.25% bupivacaine(0.5-1ml/kg) alone and combination of 0.25% bupivacaine(0.5-1ml/kg) with tramadol(1mg/kg).
A randomized clinical trial was conducted at department of Anesthesiology, Shaikh Zayed Hospital, Lahore. Study duration was 1 year and 6 months (February 2015-August 2016). A sample size of 108 patients was calculated using WHO calculator. Non probability consecutive sampling was used. Patients were randomly divided into two different group; Group B was given Bupivacaine 0.25% alone while group BT was provided with combination of bupivacaine and tramadol. Patients were observed for sedative scores, FLACC pain scores and adverse effects in both interventional groups. Data was analyzed using SPSS version 22. Student T-test was applied on data. P value ≤0.05 was considered significant.
Total 108 patients were included in study (1:1 randomization). Mean age of patients was 6.41 year±1.77SD. There were 92(85.2%) male and 16(14.8%) female. Mean sedative scores (p=0.00) and mean FLACC pain scores (p=0.000) were significantly lower in bupivacaine tramadol group as compared bupivacaine group. However, Bupivacaine group had more adverse effects as compared to combination of bupivacaine and tramadol group.
Caudal bupivacaine plus tramadol had high post operative analgesic efficacy and limited adverse effects as compared to bupivacaine alone in children undergone general anaesthesia for lower abdominal surgery.

Key words: Caudal epidural block, Bupivacaine tramadol, analgesic

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