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Caudal bupivacaine-tramadol combination for postoperative analgesia in pediatric herniorrhaphy.
- Source :
-
Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2001 Jul; Vol. 45 (6), pp. 786-9. - Publication Year :
- 2001
-
Abstract
- Background: Administration of bupivacaine caudally has been used for postoperative analgesia after urogenital, rectal and lower abdominal surgery in children. Caudal opioids may offer analgesic advantages over bupivacaine alone but have been associated with side effects such as respiratory depression. Tramadol is an analgesic assumed to lack a respiratory depressant effect and has been shown to provide effective, long-lasting analgesia after epidural administration in adults and children. The aim of this study was to determine whether the addition of tramadol to bupivacaine caudally prolongs the duration of analgesia compared with bupivacaine alone, with respect to side effects, and whether caudal tramadol alone provides satisfactory analgesia.<br />Methods: Sixty boys, aged 12-84 months, undergoing unilateral herniorrhaphy, were allocated randomly to three groups. Children in group B received 0.25% plain bupivacaine 1 ml kg(-1), group BT received an identical local anesthetic dose mixed with tramadol 1.5 mg kg(-1) and group T received caudal tramadol 1.5 mg kg(-1) in 0.9% sodium chloride in the same total volume (1 ml kg(-1)). Pain and demeanour assessments were made 1, 2, 3, 4, 6, 12 and 24 h after recovery from anesthesia with reference to a three-point scale.<br />Results: Analgesia time (time between caudal injection and first administration of analgesic) in group BT (13.5+/-2.2 h) was significantly longer than in the other two groups (P<0.05). In group T, more patients required additional analgesia after surgery than in the other two groups (P<0.05). Pain scores in the three groups were similar up to 4 h after operation but the mean score in group T was higher than groups B and BT 4 and 6 h after operation (P<0.05). Significantly more patients who had received caudal bupivacaine alone or with tramadol had lower pain and demeanour scores during the first 24 h after operation compared with those in the tramadol group.<br />Conclusion: Caudal administration of bupivacaine with the addition of tramadol resulted in superior analgesia with a longer period without demand for additional analgesics compared with caudal bupivacaine and tramadol alone without an increase of side effects.
- Subjects :
- Analgesics, Opioid administration & dosage
Analgesics, Opioid adverse effects
Anesthetics, Local administration & dosage
Anesthetics, Local adverse effects
Bupivacaine administration & dosage
Bupivacaine adverse effects
Child, Preschool
Drug Therapy, Combination
Heart Rate drug effects
Humans
Infant
Male
Nerve Block
Oximetry
Pain Measurement
Respiratory Function Tests
Tramadol administration & dosage
Tramadol adverse effects
Analgesics, Opioid therapeutic use
Anesthetics, Local therapeutic use
Bupivacaine therapeutic use
Herniorrhaphy
Pain, Postoperative drug therapy
Tramadol therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0001-5172
- Volume :
- 45
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Acta anaesthesiologica Scandinavica
- Publication Type :
- Academic Journal
- Accession number :
- 11421842
- Full Text :
- https://doi.org/10.1034/j.1399-6576.2001.045006786.x