CAUDAL ANALGESIA IN CHILDREN;

Background: Caudal analgesia with bupivacaine is used commonly for pain relief in children and extradural administration oftramadol seems to be a safe method of analgesia. The aim of the study was to compare the analgesic efficacy of caudal bupivacaine andbupivacaine and tramadol mixture for postoperative analgesia and to observe for the side effects. Setting: Department of Anesthesia andIntensive Care Unit, Bahawal Victoria Hospital, Bahawalpur. Period: 01-12-2010 to 30-11-2011. Methods: Eighty children, aged between 2 to12 years of age undergoing infra umbilical surgeries were selected for this randomized, controlled trial. They were randomly divided into twogroups A and B. Group A (n = 40) received 0.5 ml/kg of 0.25 % bupivacaine and Group B (n = 40) received 0.5 ml/kg of 0.25 % bupivacaine with 1mg/kg of tramadol as a single shot caudal block. In the postoperative period, duration of analgesia, pain score, nausea, vomiting and sideeffects were noted and analyzed. Results: Patients in both groups were comparable for age and weight. It was observed that the meanduration of analgesia in group A patients was 6.23+0.68 hours while in group B, it was 9.33+0.72 hours (p<0.05). Nausea and vomiting waspresent in 20% (n=8) patients in group A, while in group B, 27.5% (n=11) had nausea and vomiting in the post operative period (p<0.05). None ofthe patients in both the groups had complications like motor weakness, urinary retention in the postoperative period. Conclusions: Theaddition of tramadol to bupivacaine in the caudal analgesic technique provides longer analgesia and lesser need for rescue analgesia in thepostoperative period compared to bupivacaine alone.