Comparative Clinical Evaluation of Caudal Bupivacaine vs. Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia
Objectve: Effective postoperative pain management is crucial in pediatric patients undergoing infraumbilical surgeries. Various regional anesthesia techniques, including caudal block, have been used to provide postoperative analgesia in children. The addition of tramadol, a synthetic opioid analgesic, to bupivacaine in caudal anesthesia has shown potential benefits. This study aims to compare the clinical efficacy of single shot caudal bupivacaine alone versus bupivacaine plus tramadol for postoperative analgesia in pediatric infra-umbilical surgeries.
Method:
A prospective, randomized, double-blinded clinical study was conducted at our institute . The present study will be carried out in 60 paediatric patients of ASA grade I and II between the age of 1-8 years, undergoing infraumbilical surgeries. These children were randomly divided into 2 groups.
Group B (n=30) received caudal block with 0.25% bupivacaine (1ml/kg) and BT Group (n=30) received caudal block with 0.25% bupivacaine (1ml/kg) with tramadol (1mg/kg).
The variables studied were hemodynamic changes, duration of analgesia and incidence of side effects. Pain assessment was done at 1,2,3,4,8,12, and 24 hours postoperatively using Modified objective pain scale.
Results:
It was observed that the mean duration of analgesia in Group BT (9.05±2.21) hrs was significantly longer (p=0.0001) than Group B (3.78±0.94) hrs. Hemodynamic parameters remained comparable during intraoperative and postoperative periods. There were no incidence of nausea, vomiting, bradycardia, hypotension, pruritis or decrease in respiratory rate in the two groups.
Conclusion:
In our study we concluded that a single shot caudal block with 0.25% bupivacaine (1ml/kg) plus Tramadol (1mg/kg) resulted in longer duration of analgesia when compared to 0.25% bupivacaine (1ml/kg) alone with no incidence of any side effects
