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Category: Volume 06 Issue 02 February 2018
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Title: Post-Operative Analgesia in Children: A Comparison between Caudal Bupivacaine with Buprenorphine and Caudal Bupivacaine with Rectal Diclofenac

Authors: Dr Harsh Kumar Harsh, Dr Anita Harsh, Dr Prafful Kachhwaha

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.112

Abstract

Background: Relief of post-operative pain is provided traditionally by single drug regimens but combinations of different regimens have been suggested to be more rational and effective. Rectal administration of NSAIDs in children is a safe and convenient route of drug absorption. The present study was designed to compare the efficacy and safety of caudal bupivacaine (0.125%) either with buprenorphine (4µg/ml) or with rectal diclofenac suppository (2.5 mg/kg).

Material & Methods: The present study was carried out on 50 children in the Department of Anaesthesiology and critical care at the attached group of hospitals, Dr. S.N. Medical college, Jodhpur. The randomly selected children belonging to either sex were allocated to two groups, each group consisted of 25 children. Routine monitoring of every child included precordial stethoscope, ECG, NIBP, SpO2 through pulse oxymeter and temperature. After surgery the children were transferred to recovery ward and were observed up to 1 hour and then in post-operative ward at 1, 4, 6, 12, 24 hours.

Results: Our study showed that the mean age of patients in group A was 4.78±2.446 yrs and group B was 5.240±2.521 yrs, it was not statistically significant (P>0.05) and mean values of weight and duration of surgery were also not statistically significant (P>0.05 respectively). At 6 hours of observation one patient in group A and 2 patients in group B demanded for rescue analgesia. At 12 hours of observation 4 patients from both groups demanded for rescue analgesia.

Conclusion: We concluded that caudal bupivacaine 0.125% in a dose of 1 ml/kg with rectal diclofenac Na suppository in a dose of 2.5 mg/kg just after induction of anaesthesia provides equivalent analgesia up to 24 hour in postoperative period with minimum side effects and lesser incidences of nausea and vomiting, sedation, time taken to void urine, in comparison to caudal bupivacaine in the same dose along with buprenorphine.

Keywords: Post-operative pain, Caudal anaesthesia, Buprenorphine, Bupivacaine, Rectal diclofenac Na.

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Corresponding Author

Dr Anita Harsh

Associate Professor, Department of Pathology, S.M.S. Medical College, Jaipur

Address: 241/3, Parwati Marg, Raja Park, Jaipur-302004 India

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