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Two different doses of caudal neostigmine co‐administered with levobupivacaine produces analgesia in children
Author(s) -
KARAASLAN KAZIM,
GULCU NEBAHAT,
OZTURK HAYRETTIN,
SARPKAYA ALI,
COLAK CEMIL,
KOCOGLU HASAN
Publication year - 2009
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2009.02969.x
Subject(s) - levobupivacaine , medicine , neostigmine , analgesic , anesthesia , adverse effect , visual analogue scale , incidence (geometry) , physics , optics
Summary Background: This study was aimed to evaluate the analgesic efficacy, duration of analgesia, and side effects of two different doses of caudal neostigmine used with levobupivacaine in children. Methods: Sixty boys, between 5 months and 5 years, undergoing genito‐urinary surgery were allocated randomly to one of three groups ( n = 20 each). Group I patients received caudal 0.25% levobupivacaine (1 ml·kg −1 ) alone. Groups II and III patients received neostigmine (2 and 4 μg·kg −1 respectively) together with levobupivacaine used in the same dose as Group I. Pain scores were assessed using Children’s and Infant’s Postoperative Pain Scale (CHIPPS) at 15th (t 1 ) min after arrival to postanesthetic care unit, and 1st (t 2 ), 2nd (t 3 ), 3rd (t 4 ), 4th (t 5 ), 8th (t 6 ), 16th (t 7 ), and 24th (t 8 ) hour postoperatively. Duration of analgesia, amount of additional analgesic (paracetamol), score of motor blockade and complications were recorded for 24 h postoperatively, and compared between groups. Results: CHIPPS scores were higher during t 2 , t 3 , t 6 , t 7 and t 8 periods, duration of analgesia was shorter, and total analgesic consumption was higher in Group I compare to neostigmine groups ( P < 0.05). Duration of postoperative analgesia and total analgesic consumption were similar in Groups II and III ( P > 0.05). Adverse effects were not different between three groups. Conclusions: Caudal neostigmine in doses of 2 and 4 μg·kg −1 with levobupivacaine extends the duration of analgesia without increasing the incidence of adverse effects, and 2 μg·kg −1 seems to be the optimal dose, as higher dose has no further advantages.