Postoperative analgesic efficacy of caudal tramadol added to bupivacaine compared to bupivacaine alone for pediatric elective infra umbilical surgery at Tikur Anbessa Specialized Hospital, Ethiopia, a prospective cohort study

Angasa, Dugo; Haddis, Lidya; Gashaw, Amanu; Zemedkun, Abebayehu; Gobena, Negeso

doi:10.1016/j.ijso.2020.10.008

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…These findings were comparable to the previous studies. [11,12] During the first 24 hours, we noticed a reduced pain score in the bupivacaine-tramadol group as compared to group II with p value <0.002. When it comes to postoperative analgesia, the bupivacaine-tramadol group had much longer analgesia durations and a significantly lower need for rescue analgesia with p value <0.003.…”

Section: Discussionmentioning

confidence: 78%

Comparison of Caudal Bupivacaine and Bupivacaine-tramadol Combination for Postoperative Analgesia in Children Undergoing Lower Abdominal Surgeries

Shamsuddin¹,

Siddiqui²,

Zeb³

et al. 2022

PJMHS

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Objective: The aim of current study is to determine the effectiveness of caudal bupivacaine and bupivacaine-tramadol combination for postoperative analgesia in children undergoing lower abdominal surgeries. Study Design: Randomized Control trial Place and Duration: Department of Anesthesiology Surgical ICU & Pain Management Ghulam Muhammad Mahar Medical College, Sukkur and Lahore General Hospital, Lahore, during the period from March 2021 to August 2021. Methods: There were 110 children of both genders with ages 2-8 years undergoing lower abdominal surgery were included in this study. A detailed demographics of enrolled patients, including age, sex, and weight were computed after obtaining informed written consent from each individual. Patients were equally divided in two groups. Group I had 55 patients and received combination of tramadol (1 mg/kg) and bupivacaine (0.5 ml/kg of 0.25%) and group II received only bupivacaine 0.5 ml/kg of 0.25% after induction of anesthesia in caudal epidural space. Post-operatively pain score, requirement of rescue analgesia and sedation score was assessed and compared among both groups. SPSS 24.0 was used to analyze complete data. Results: There majority males 35 (63.6%) in group I and 32 (58.2%) in group II. In group I mean age of the patients was 5.9±4.61 years and in group II mean age were 4.8±9.44 years. Mean weight of the patients in group I was 17.6±4.52 kg and in group II mean weight was 19.5±7.34 kg. During the first 24 hours, we noticed a reduced pain score in the bupivacaine–tramadol group. When it comes to postoperative analgesia, the bupivacaine-tramadol group had much longer analgesia durations and a significantly lower need for rescue analgesia with p value <0.003. Postoperative frequency of adverse effects in group II was greater found in 4 (7.3%) cases as compared to group I in 1 (1.8%) patients. Conclusion: In children having abdominal surgery, we found that caudal tramadol with bupivacaine provided more extended and better quality postoperative analgesia than plain bupivacaine. Keywords: Tramadol, Bupivacaine, Abdominal Surgery, Pain Score, Rescue Analgesia

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Section: Discussionmentioning

confidence: 78%

Comparison of Caudal Bupivacaine and Bupivacaine-tramadol Combination for Postoperative Analgesia in Children Undergoing Lower Abdominal Surgeries

Shamsuddin¹,

Siddiqui²,

Zeb³

et al. 2022

PJMHS

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“…A recent study conducted by Angasa et al (2020) [18] in children aged 1-14-year old undergoing elective infraumbilical surgery received caudal block with bupivacaine 0.25% 1 mL/kg and bupivacaine 0.25% 1 mL/kg with tramadol 1 mg/kg. The mean pain score was lower in (BT) group with a statistically significant difference at 4 th , 8 th , and 12 th h post-operatively with p=0.018, 0.002, and 0.041, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparative Clinical Evaluation of Caudal Bupivacaine Versus Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

AYUSHEE KHANDELWAL,

RASHMI GUPTA,

SURESH PANDEY

2023

Asian J Pharm Clin Res

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Objective: Effective post-operative pain management is crucial in pediatric patients undergoing infraumbilical surgeries. Various regional anesthesia techniques, including caudal block, have been used to provide post-operative analgesia in children. The addition of tramadol, a synthetic opioid analgesic, to bupivacaine in caudal anesthesia has shown potential benefits. This study aims to compare the clinical efficacy of single-shot caudal bupivacaine alone versus bupivacaine plus tramadol for post-operative analgesia in pediatric infra-umbilical surgeries. Methods: A prospective, randomized, double-blinded clinical study was conducted at our institute. The present study will be carried out in 60 pediatric patients of the American Society of Anesthesiologists Grades I and II between the age of 1 and 8 years, undergoing infraumbilical surgeries. These children were randomly divided into 2 groups. Group B (n=30) received caudal block with 0.25% bupivacaine (1 mL/kg) and Group BT (n=30) received caudal block with 0.25% bupivacaine (1 mL/kg) with tramadol (1 mg/kg). The variables studied were hemodynamic changes, duration of analgesia, and incidence of side effects. Pain assessment was done at 1, 2, 3, 4, 8, 12, and 24 h post-operatively using modified objective pain scale. Results: It was observed that the mean duration of analgesia in Group BT (9.05±2.21) h was significantly longer (p=0.0001) than Group B (3.78±0.94) h. Hemodynamic parameters remained comparable during intraoperative and post-operative periods. There was no incidence of nausea, vomiting, bradycardia, hypotension, pruritus, or decrease in respiratory rate in the two groups. Conclusion: In our study, we concluded that a single-shot caudal block with 0.25% bupivacaine (1 mL/kg) plus tramadol (1 mg/kg) resulted in longer duration of analgesia when compared to 0.25% bupivacaine (1 mL/kg) alone with no incidence of any side effects.

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“…Recently, various bupivacaine supplements have been used in many paediatric surgeries to increase the duration and quality of pain relief. Addition of tramadol to bupivacaine resulted in a dose-dependent upsurge in analgesia postoperatively [16][17] . This study showed a clinically and statistically substantial period of postoperatively pain reduction.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study on Caudal Bupivacaine with and without Tramadol for Analgesia Postoperatively in Paediatric Inguino Scrotal Surgeries

Ashfaq¹,

Asghar²,

Channa³

et al. 2022

PJMHS

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Objective: The objective of this analysis was to govern the analgesic effect of tramadol with caudal bupivacaine in children enduring inguinal-scrotal surgery postoperatively. Study design: A Quasi experimental study. Methods: In this comparative and double-blind study, 120 children undergoing inguinal scrotal surgery were involved in the analysis. They were 2-12 years old. The inclusion standards were children from ASA I and II. The two identical groups were formed. After initiation of general anesthesia, group A patients (n = 60) 0.25% bupivacaine 0.75 ml / kg was administered and tramadol 1 mg / kg with 0.25% bupivacaine 0.75 ml / kg were administered in B group (n = 60). Postoperative pain was evaluated with a visual analogue pain score in 6-7 years of age children and with behavioural reflexion in pre-speech children. Using a 4-point sedation scale; Sedation was assessed; heart rate, mean arterial pressure, arterial oxygen saturation and respiration rate. The sedation and pain were documented at consistent duration up to 24 hours after surgery immediately after recovery from anesthesia. If the pain score was higher than 4, paracetamol (20 mg / kg) was administered rectally. Results: Addition of intravenous bupivacaine and tramadol suggestively have longer postoperative analgesia (10.1 ± 2.1 hours) in group B, while the mean duration of analgesia (2.90 ± 0.79 hours) in group A, where bupivacaine alone was, provided. No significant changes were observed in blood pressure, O2 saturation and heart rate between groups. Apart from vomiting and nausea, no side effects like retention of urine, depression and pruritus were observed. Conclusion: In children undergoing inguinal scrotal surgery, caudal bupivacaine and tramadol have more lasting and better postoperative analgesia than bupivacaine alone. Keywords: Postoperative analgesia, tramadol, Caudal and bupivacaine.

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Postoperative analgesic efficacy of caudal tramadol added to bupivacaine compared to bupivacaine alone for pediatric elective infra umbilical surgery at Tikur Anbessa Specialized Hospital, Ethiopia, a prospective cohort study

Cited by 3 publications

References 6 publications

Comparison of Caudal Bupivacaine and Bupivacaine-tramadol Combination for Postoperative Analgesia in Children Undergoing Lower Abdominal Surgeries

Comparison of Caudal Bupivacaine and Bupivacaine-tramadol Combination for Postoperative Analgesia in Children Undergoing Lower Abdominal Surgeries

Comparative Clinical Evaluation of Caudal Bupivacaine Versus Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

A Comparative Study on Caudal Bupivacaine with and without Tramadol for Analgesia Postoperatively in Paediatric Inguino Scrotal Surgeries

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