CAUDAL BUPIVACAINE-TRAMADOL COMBINATION FOR POSTOPERATIVE PAIN RELIEF IN PEDIATRIC
SURGERY
Sanaa S.r Mohamed MDV Mohamed Y. Sen i Ml:. Motiamed M. Khamis MD., and Reda 1C Kamel MO,
From: Department of Anesthesia, Benha Faculty of Medlcir*, Zagazig university Egypt
\BSTRACT
The efficacy or caudal buplvacalne, - •• -livacaine-tramadol combination; and tramadol alone m postoperative analgesia was studied on sixty ASA I physical status male children aged 13-59 months undergoing elective surgery under general anesthesia. After Induction of general a-.esmeia and before surgical Jndslcc children were allocated randomly into 3 equal groups (20 Ddtients each) according to Ihe drug used for caudaf analge&.a: Group B received 0-8 ml/kg rf tupiv&aine 0.25% (2.5 mg/mL) plus 1 mL normal saline, group BT received O.B ml/kg of previous solution plus 2 mg kg tranvidof In 1 mL, group T received 0.8 mL/kg of diluted tramadol 2,5 mg/rnL plus 1 ml normal saline,
to the surgical wards the following parameters were recorded: pain (assessed by a modified TWPS pain score (oral paracetamol was given when pain scores more than 3)x duration of caudal analgesia (defined from the time of caudal Injection oil The first analgesic requirement), sedation sore, heart rate, mean arterial bleed pressure, respiratory rate, oxygen saturation and occurrence of side effects,
Our results showed frai the duration of caiidaJ analgesia in group bt (16,S ± 5.6 hours) was longer (P<C,QQ1) than in the other 2 groups. Number of children wtio maintained analgesia without the need of rescue analgesic was more in group BT (75%), than in B and trarnadol groups T (0%), Also fewer doses of oral paracetamol wets given to group BT than In groups B and T which was significant (P<0,001). There were no significant tifferences in the 3 groups as regaras to sedation score, heart rate, mean arterial Hood pressure, respiratory rate and oxygen saturation.
v,e conclude that caudal administration of buolvaume with the addition of tramacol resulted In sLperior analgesia with a longer period without demand for additional analgesia compared with caudal bupivacaine and tramactol atone wiihout an Increase of side effects.
author correspondence
Or. Recta KhalH Kamel, f-*-rerr Department of Anesthesia, Facuty of Medicine, Senna University <redakamel@hotmalcom>
accepted ow:
February 23,2002 <Ef words:
Pediatrtc, postoperative pain, Caudal tramadol Caudal Buplvacalne - tramactol mfcrture.