Abstract

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 1 ml/kg

b. Group II: 0.125 Inj. Bupivacaine 1 ml/kg plus Inj. Fentanyl 1 mcg/kg

c. Group III: 0.125% Inj. Bupivacaine 1 ml/kg plus Inj. Tramadol 2 mg/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.

Keywords: Caudal; Bupivacaine; Fentanyl; Tramadol; Pediatric; Analgesia; Haemodymamic; Anesthesiologist; Infraumbilical; Glycopyrrolate; Capnography; postoperative analgesia; Enantiomer; Infraumbilical surgeries; Norepinephrine; Pethidine; Ropivacaine; Midazolam; Glycopyrrolate; Sevoflurane; Opioid receptors; Atracurium; Substantialgelatinous; fluctuation

Abbreviations:ASA: American Society of Anesthesiologist; ECG: electrocardiogram; NIBP: Non Invasive Blood Pressure; MOP: Modified Objective Pain Score.