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Caudal-epidural bupivacaine versus ropivacaine with fentanyl for paediatric postoperative analgesia.

Sengupta S, Mukherji S, Sheet J, Mandal A, Swaika S - Anesth Essays Res (2015 May-Aug)

Bottom Line: Though, bupivacaine is the most commonly used drug for this purpose, ropivacaine has emerged as a safer alternative, with the addition of opioids, like fentanyl, increasing the effective duration of analgesia.Perioperative hemodynamics and any adverse effects were monitored at regular intervals.The RF Group experienced significantly longer duration of effective postoperative analgesia, with significantly shorter duration of motor blockade and lesser total analgesic requirement in comparison to the BF Group.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Critical Care, Medical College and Hospital, Kolkata, India.

ABSTRACT

Background and aims: Caudal-epidural, the most commonly used regional analgesia technique, is virtually free of measurable hemodynamic effects, thus adding a new dimension to the evolving necessity of pediatric postoperative pain management. Though, bupivacaine is the most commonly used drug for this purpose, ropivacaine has emerged as a safer alternative, with the addition of opioids, like fentanyl, increasing the effective duration of analgesia. With this overview, our present study was designed to compare the postoperative analgesic efficacy of bupivacaine-fentanyl and ropivacaine-fentanyl combinations by caudal-epidural technique in pediatric infraumbilical surgeries.

Materials and methods: Totally, 60 pediatric patients, of either sex, aged between 2 and 8 years, American Society of Anesthesiologists physical status I and II, undergoing elective infraumbilical surgeries were assigned into two groups, Group BF receiving bupivacaine 0.25%, 0.7 ml/kg and Group RF receiving ropivacaine 0.25%, 0.7 ml/kg with fentanyl 1 μg/kg added to each group. Assessment of pain was done using "Hannallah pain scale." Consumption of the total amount of rescue analgesic and time to requirement of the first dose, as also duration of motor blockade were noted. Perioperative hemodynamics and any adverse effects were monitored at regular intervals.

Results: The RF Group experienced significantly longer duration of effective postoperative analgesia, with significantly shorter duration of motor blockade and lesser total analgesic requirement in comparison to the BF Group. Hemodynamically, patients in both the groups, were equally stable.

Conclusion: Ropivacaine, with an equipotent analgesic efficacy and a lesser duration of motor block, can be used as an alternative to bupivacaine for pediatric postoperative pain care through the caudal route.

No MeSH data available.


Related in: MedlinePlus

Comparison of heart rate (HR) in two groups. Abscissa represents the observation intervals in minutes and ordinate represents HR per minute in given interval
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Figure 1: Comparison of heart rate (HR) in two groups. Abscissa represents the observation intervals in minutes and ordinate represents HR per minute in given interval

Mentions: There were no significant differences in the side-effect profile [Table 3] and the hemodynamic parameters [Figures 1 and 2] between the two groups.


Caudal-epidural bupivacaine versus ropivacaine with fentanyl for paediatric postoperative analgesia.

Sengupta S, Mukherji S, Sheet J, Mandal A, Swaika S - Anesth Essays Res (2015 May-Aug)

Comparison of heart rate (HR) in two groups. Abscissa represents the observation intervals in minutes and ordinate represents HR per minute in given interval
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563976&req=5

Figure 1: Comparison of heart rate (HR) in two groups. Abscissa represents the observation intervals in minutes and ordinate represents HR per minute in given interval
Mentions: There were no significant differences in the side-effect profile [Table 3] and the hemodynamic parameters [Figures 1 and 2] between the two groups.

Bottom Line: Though, bupivacaine is the most commonly used drug for this purpose, ropivacaine has emerged as a safer alternative, with the addition of opioids, like fentanyl, increasing the effective duration of analgesia.Perioperative hemodynamics and any adverse effects were monitored at regular intervals.The RF Group experienced significantly longer duration of effective postoperative analgesia, with significantly shorter duration of motor blockade and lesser total analgesic requirement in comparison to the BF Group.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Critical Care, Medical College and Hospital, Kolkata, India.

ABSTRACT

Background and aims: Caudal-epidural, the most commonly used regional analgesia technique, is virtually free of measurable hemodynamic effects, thus adding a new dimension to the evolving necessity of pediatric postoperative pain management. Though, bupivacaine is the most commonly used drug for this purpose, ropivacaine has emerged as a safer alternative, with the addition of opioids, like fentanyl, increasing the effective duration of analgesia. With this overview, our present study was designed to compare the postoperative analgesic efficacy of bupivacaine-fentanyl and ropivacaine-fentanyl combinations by caudal-epidural technique in pediatric infraumbilical surgeries.

Materials and methods: Totally, 60 pediatric patients, of either sex, aged between 2 and 8 years, American Society of Anesthesiologists physical status I and II, undergoing elective infraumbilical surgeries were assigned into two groups, Group BF receiving bupivacaine 0.25%, 0.7 ml/kg and Group RF receiving ropivacaine 0.25%, 0.7 ml/kg with fentanyl 1 μg/kg added to each group. Assessment of pain was done using "Hannallah pain scale." Consumption of the total amount of rescue analgesic and time to requirement of the first dose, as also duration of motor blockade were noted. Perioperative hemodynamics and any adverse effects were monitored at regular intervals.

Results: The RF Group experienced significantly longer duration of effective postoperative analgesia, with significantly shorter duration of motor blockade and lesser total analgesic requirement in comparison to the BF Group. Hemodynamically, patients in both the groups, were equally stable.

Conclusion: Ropivacaine, with an equipotent analgesic efficacy and a lesser duration of motor block, can be used as an alternative to bupivacaine for pediatric postoperative pain care through the caudal route.

No MeSH data available.


Related in: MedlinePlus