Caudal block with rectal diclofenac and paracetamol for pediatrics infra umbilical surgery at a comprehensive specialized teaching hospital in Ethiopia

Abstract

Background Caudal block is a common regional technique performed for infra umbilical surgery in pediatrics. Its limited duration of analgesia remains a gap in routine clinical practice. This study aimed to assess the analgesic effectiveness of caudal block with rectal diclofenac or rectal paracetamol among pediatric patients who underwent infra umbilical surgery. Methods A prospective cohort study was conducted on patients aged 1–10 years that underwent elective infra umbilical surgery. Patients were allocated into the Caudal block with rectal Diclofenac, Caudal block with rectal Paracetamol, and Caudal block alone groups based on a postoperative pain management plan. Analysis of variance was used for normally distributed data and the Kruskal Wallis H test was used for non-normally distributed. The Tukey for post hoc test was used to compare the difference between groups one with the others. Categorical data were analyzed by using Pearson Chi-squared or Fisher's exact test as appropriate. A p-value < 0.05 considered as statistically significant. Results The postoperative median pain score was lower in CD compared to CP and CA group (p-value < 0.001) at the 4th and 8th hour. Time to first analgesic request was significantly longer within CD 735 (540–1200 min) compared to CP 445 (240–840 min p = 0.029) and CA 315 (240–720 min p < 0.001). Conclusion The pain score and total postoperative analgesic consumption were significantly reduced in addition to prolonged-time to request the first analgesia in the CD group compared to CA and CP group.

Effectiveness of a new regional anesthetic mixture on pain control after pediatric heart surgery: a systematic randomized trial

“…These conditions include the skull block for craniotomies. Even for very well-local techniques like the caudal block, it was significant to observe that the evidence defending treatment regimen indications is now inadequately defined [17]. One study produced contradictory results when the caudal block in an inguinal operation was compared to the control.…”

Postoperative Analgesia After Inguinal Herniotomy in Children; A Comparison of Combination of Intravenous Paracetamol and Rectal Diclofenac with Caudal Bupivacaine

“…Zewdu et al 14 reported that in the caudal-diclofenac group compared to the caudal alone and caudal-paracetamol groups, the pain score, the total amount of postoperative analgesics used, and the time it took to request the first analgesics were all significantly lower. The use of rectal route is efficient as it avoids first pass metabolism.…”