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  2. Volume 9, Issue 5
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Online ISSN: 2515-8260

Volume9, Issue5

Comparative study of 0.25% bupivacaine and 0.25% bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing lower abdominal surgery

    Dr. Karnakar V, Dr. Yugandhar Kandula, Dr. Suresh Janapati, Dr. Kiran Kumar Suggala

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 126-131

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Abstract

Background: Caudal epidurals are commonly performed for postoperative pain management in children undergoing abdominal and lower limb surgeries. Bupivacaine is considered the most common local intrathecal anesthesia for children. Various adjuvants were combined with the local anesthetic to increase intrathecal block quality and extend analgesia duration. Present study was aimed to compare bupivacaine versus bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing lower abdominal surgery.
Material and Methods: Present study was comparative, double blind, observational study, conducted in children aged between 1 and 10 years, either gender, ASA class I and II, scheduled to undergo lower abdominal surgery, parents consented for participation. Children were divided as Group A, receiving bupivacaine 0.25% 2 mg/kg with fentanyl (1μg/kg) & Group B receiving bupivacaine 0.25% 2 mg/kg only.
Results: Onset of Sensory block (mins) & Time to achieve the optimum level (mins) were comparable among both groups & difference was not significant statistically. We noted more duration of motor block (176.4 ± 64.4 min vs 154.5 ± 52.13 min), Prolonged duration of postoperative analgesia (320.3 ± 41.19 min vs 288.3 ± 43.1 min), less amount of rescue analgesic (73.33 ± 44.28 mg vs 85.17 ± 44.45 mg) & late requirement of rescue analgesic (272.67 ± 37.38 min vs 236.83 ±10.63) in A group as compared to Group B & difference was significant statistically. PONV & pruritis were noted in 1 patient each from group A as compared to 3 cases of PONV & 1 case of pruritis & difference was not significant statistically.
Conclusion: 1µg/kg fentanyl with 0.25%bupivacaine 2mg/kg when administered caudally provide satisfactory surgical anesthesia and post-operative analgesia with prolonged period of analgesia with without any major postoperative complications. Fentanyl produces a faster onset of analgesia with fewer side effects like nausea, vomiting.
Keywords:
    Bupivacaine caudal‑epidural analgesia fentanyl pediatric surgery
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(2022). Comparative study of 0.25% bupivacaine and 0.25% bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing lower abdominal surgery. European Journal of Molecular & Clinical Medicine, 9(5), 126-131.
Dr. Karnakar V, Dr. Yugandhar Kandula, Dr. Suresh Janapati, Dr. Kiran Kumar Suggala. "Comparative study of 0.25% bupivacaine and 0.25% bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing lower abdominal surgery". European Journal of Molecular & Clinical Medicine, 9, 5, 2022, 126-131.
(2022). 'Comparative study of 0.25% bupivacaine and 0.25% bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing lower abdominal surgery', European Journal of Molecular & Clinical Medicine, 9(5), pp. 126-131.
Comparative study of 0.25% bupivacaine and 0.25% bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing lower abdominal surgery. European Journal of Molecular & Clinical Medicine, 2022; 9(5): 126-131.
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