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document
A comparative study of caudal bupivacaine and midazolam-bupivacaine mixture for post-operative analgesia in children undergoing genitourinary surgery . OBJECTIVE This study was designed to evaluate the analgesic efficacy of caudal midazolam-bupivacaine combination in providing post-operative pain relief in children undergoing genitourinary surgery and to study the occurrence of adverse effects . SUBJECTS AND METHODS Thirty children , aged 2 to 8 years , scheduled for genitourinary surgery were allocated randomly to receive either 0.25 % bupivacaine 0.5 ml/kg ( group B ; n = 15 ) or 0.25 % bupivacaine 0.5 ml/kg with 50 microg/kg midazolam ( group BM ; n = 15 ) by the caudal route immediately after induction of general anesthesia . Heart rate , arterial blood pressure and oxygen saturation were monitored throughout the study period . Postoperative pain was assessed at regular intervals for 12 hours using an objective pain score . Analgesia was supplemented whenever the pain score was > or = 4 . Duration of analgesia , as well as the requirement of additional analgesics , were noted . RESULTS Lowest pain scores were observed with the addition of midazolam to caudal bupivacaine ( p < 0.01 ) . Duration of analgesia was longer in group BM ( 11 +/- 0.5 h ) as compared to group B ( 7.4 +/- 2.1 hours ) ( p < 0.05 ) . Fewer children ( 26.6 % ) required additional analgesia in the combination group whereas in group B , 60 % of the children received analgesic supplements within 6 hours after surgery ( p < 0.05 ) . There were no significant changes in heart rate , blood pressure and oxygen saturation in both groups . We observed no untoward event in either of the groups . CONCLUSION Caudal administration of bupivacaine-midazolam mixture prolongs post-operative analgesia compared to bupivacaine alone without causing any adverse effects .
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Intervention_Pharmacological
caudal bupivacaine and midazolam-bupivacaine mixture
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Intervention_Pharmacological
caudal midazolam-bupivacaine combination
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Intervention_Pharmacological
bupivacaine
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Intervention_Pharmacological
bupivacaine 0.5 ml/kg with 50 microg/kg midazolam
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Intervention_Pharmacological
midazolam to caudal bupivacaine
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Intervention_Pharmacological
Caudal administration of bupivacaine-midazolam mixture
6420
Intervention_Pharmacological
bupivacaine
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Outcome_Physical
Heart rate
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Outcome_Physical
arterial blood pressure
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Outcome_Physical
oxygen saturation
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Outcome_Pain
Postoperative pain
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Outcome_Pain
pain score
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Outcome_Physical
Analgesia
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Outcome_Pain
pain score
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Outcome_Other
Duration of analgesia
6429
Outcome_Pain
pain scores
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Outcome_Other
Duration of analgesia
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Outcome_Physical
additional analgesia
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Outcome_Physical
analgesic supplements
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Outcome_Physical
heart rate
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Outcome_Physical
blood pressure
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Outcome_Physical
oxygen saturation
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Outcome_Physical
untoward event
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Participant_Condition
children undergoing genitourinary surgery .