Comparison of Post-operative Analgesic Efficacy of Caudal Epidural Bupivacaine Versus Bupivacaine and Neostigmine Combination in Infraumbilical Surgeries in Children.
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Date
2013-05
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Abstract
Spinal muscarinic M1 receptors are believed to be
involved in the analgesic properties of spinal neostigmine.
Aims were to determine the effect of adding neostigmine
to bupivacaine on the duration of caudal analgesia as
compared with caudal bupivacaine alone, to determine the
need for rescue analgesics in the post-operative period.
Material and Methods: 50 patients of ASA Grade I and II,
aged between 2 to 8 years, of either sex underwent infraumbilical
surgeries. Post-operative caudal epidural analgesia
was activated after completion of the surgery and before
recovery from anaesthesia Group-A (n=25) received caudal
epidural injection of preservative free bupivacaine 0.125%.
2 mg/kg, Group-B (n=25) received both preservative free
bupivacaine 0.125% and neostigmine 2μg/kg. Results and
Analysis: After extubation children were evaluated for pain
using the CHEOPS pain scale, shows no significant
difference between the two study groups at 2 post-operative
hours. Group B patients required less rescue analgesic than
Group A patients in 24 hrs postoperative period. Conclusion:
Addition of neostigmine to bupivacaine in caudal epidural
bupivacaine prolonged the duration of caudal analgesia in
the post-operative period compared to caudal bupivacaine
alone.
Description
Keywords
caudal epidural bupivacaine, neostigmine, postoperative analgesia
Citation
Maji Sunanda, Roy Jaydeb, Gupta Sampa Dutta, Bandhyopadhyay Tibar, Kundu Kanak Kanti. Comparison of Post-operative Analgesic Efficacy of Caudal Epidural Bupivacaine Versus Bupivacaine and Neostigmine Combination in Infraumbilical Surgeries in Children. Indian Medical Gazette. 2013 May ; 147 (5): 192-198.