A Comparative Clinical Study between Clonidine and Tramadol with Bupivacaine in Caudal Epidural for Postoperative Analgesia in Pediatric Surgery.

CONTEXT

Adjuvants to bupivacaine for single shot caudal block in children.

AIMS

This study entitled was conducted to compare the effects of addition of tramadol to bupivacaine over addition of clonidine to bupivacaine as a single shot caudal block in children.

SETTINGS AND DESIGN

Sixty children of ASA grade I and II in the age group of 2-12 years coming for various infra-umbilical surgeries were included.

MATERIALS AND METHODS

They were divided into two groups of 30 each. Group BC received caudal bupivacaine 0.25% 0.5ml/kg with clonidine 2 mcg/kg Group BT received caudal bupivacaine 0.25% 0.5 ml/kg with tramadol 2 mg/kg. The main parameters studied were hemodynamic changes, duration of post-operative analgesia and incidence of adverse effects.

STATISTICAL ANALYSIS USED

The results of continuous variables are given as mean ± SD and proportion as percentage. The difference between the two groups was assessed by student's - test and chi-square test.

RESULTS

The mean duration of post-operative analgesia in group BT was statistically significant ( <0.001), reducing the requirement of analgesics in group BT. There was no difference in sedation score, nausea, vomiting, urinary retention.

CONCLUSIONS

The present study demonstrated that caudal administration of bupivacaine 0.25% 0.5 ml/kg with tramadol 2 mg/kg resulted in superior analgesia with longer duration of action and reduced requirement of analgesics in first 24 hours postoperatively when compared with 0.25% bupivacaine 0.5 ml/kg with clonidine 2 mcg/kg.