BACKGROUNDThere are no studies comparing the outcomes of using Fentanyl or Neostigmine as adjuvants to Ropivacaine in terms of postoperative analgesia for paediatric caudal block. The aim of our study is to compare the outcomes of using Ropivacaine 0.2% vs Ropivacaine 0.2% with Neostigmine 2 mcg/kg vs Ropivacaine with Fentanyl 1 mcg/kg as a single shot caudal block on postoperative analgesic effect in children aged 3 -8 yrs. undergoing subumbilical surgeries.
MATERIALS AND METHODSThis is a double-blind, randomised, controlled, prospective study. Our study included 60 paediatric patients undergoing elective lower abdominal surgeries at Rajiv Gandhi Institute of Medical Sciences, Srikakulam, Andhra Pradesh.
RESULTSThe patient groups were comparable with respect to age and weight. The mean pain scores at 24 hrs. in R, RF and RN groups are 3.05 ± 0.6, 2 ± 0.5, 2.65 ± 0.67 respectively with a p-value of 0.008, which is statistically significant. The duration of analgesia in R, RF and RN groups are 383, 353 and 680.5 mins. respectively with a p-value of ˂ 0.05, which is statistically significant.
CONCLUSIONWe conclude in the present study that the addition of neostigmine to caudal Ropivacaine resulted in prolongation of duration of analgesia, while a Ropivacaine and Fentanyl mixture did not cause any statistically significant increase in the duration of analgesia.
KEYWORDSRopivacaine, Fentanyl, Neostigmine, Caudal Analgesia.
HOW TO CITE THIS ARTICLE:Rao MP, Babu SP, Saroj P. A randomised, double-blind, prospective study of caudal ropivacaine versus ropivacaine with fentanyl versus ropivacaine with neostigmine for combined epidural and general anaesthesia in children. J. Evolution Med. Dent. Sci. 2017;6(44):3459-3468, DOI: 10.14260/Jemds/2017/748 BACKGROUND Pain is "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage" as defined by the International Association for the Study of Pain. [1] Pain is always subjective.In children even the definition of pain has been debated. [2] The structural components necessary to perceive pain are already present at about 25 weeks gestation, whereas the endogenous descending inhibitory pathways are not fully developed until mid-infancy. [3,4] It has been recognised for some time that the management of acute pain, especially post-operative pain, has been consistently inadequate. If anything, the situation in children has been even worse, who have long been undermedicated for acute pain. [5] The various drugs used for the treatment of acute postoperative pain are local anaesthetics (local/regional Financial or Other, Competing Interest: None. Submission 21-04-2017, Peer Review 19-05-2017, Acceptance 25-05-2017, Published 01-06-2017. Corresponding Author: Dr. Soumya Panickessery Babu, D/No. 39-6-72, Muralinagar, Visakhapatnam-530007. E-mail: pbsoums.k@gmail.com DOI: 10.14260/jemds/2017 analgesia), opioids, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and acetaminophen. The different availab...
