No abstract

Summary Twenty‐eight children (mean age 4.4 years) undergoing elective major upper‐abdominal or thoracic surgery were randomly selected to receive caudal morphine 0.07 mg·kg−1 in saline either before (Group One) or immediately after surgery (Group Two). Caudal morphine injection given prior to surgery significantly prolonged postoperative analgesia when compared to caudal morphine given immediately post‐surgery. Ten out of 14 children in Group One required no further analgesia over the next 24 h compared to 3 out of 14 in Group Two. There was no detectable difference in ventilatory frequency or oxygen saturation and no clinically significant respiratory depression was recorded in either group. There was no nausea, vomiting or pruritus postoperatively, which was ascribed to the use of trimeprazine and droperidol premedication, however, 30% of patients required catheterization for urinary retention.

Background: Gabapentin, an antiepileptic has over the years been used as an analgesic. It is known to have opioid sparing properties thereby reducing the use of narcotic analgesic in the perioperative period. Method : 50 patients each of ASA I-II were randomly allocated to two study groups-one group received gabapentin (1200mg) and other group received placebo 1 hour prior to surgery. Both groups received morphine (0.1mg/kg) as intraoperative analgesic at induction of anaesthesia. After the completion of mastectomy postoperative analgesia was assessed with visual analogue scale (VAS) method (0cm-no pain and 10cm-worst possible pain). Rescue analgesic was administered to patients whose VAS was above 3 (morphine 0.1mg/kg).Apart from VAS haemodynamic parameters and oxygen saturation were regularly recorded half hourly for first two hours, then hourly for next 4 hours and then 2 hourly till the patient requested for analgesia postoperatively. Result : There was a statistically significant difference (p < 0.05) among the two groups as regards the intraoperative and postoperative heart rates. Systolic blood pressure showed significant variation (p < 0.05) among the two groups. Conclusion : Prophylactic use of oral gabapentin prior to surgery reduced the incidence of pain and significant degree of analgesia was achieved in such patients as compared to placebo group. Prophylactic use of oral gabapentin before mastectomy reduced the overall consumption of morphine as well as incidence of postoperative pain.