18265
document
Caudal neostigmine with bupivacaine produces a dose-independent analgesic effect in children . PURPOSE To evaluate the analgesic efficacy and duration of varying doses of caudal neostigmine with plain bupivacaine and its side effects in children undergoing genito-urinary surgery . METHODS In a randomized double-blind prospective study 80 boys aged two to eight years scheduled for surgical repair of hypospadias were allocated randomly to one of four groups ( n = 20 each ) and received either only caudal 0.25 % plain bupivacaine 0.5 mL.kg ( -1 ) ( Group I ) or 0.25 % plain bupivacaine 0.5 mL.kg ( -1 ) with neostigmine ( Groups II-IV ) in doses of 2 , 3 and 4 microg.kg ( -1 ) respectively . Postoperative pain was assessed for 24 hr using an objective pain score . Blood pressure , heart rate , oxygen saturation , total amount of analgesic consumed and adverse effects were also recorded . RESULTS The duration of postoperative analgesia in Group I ( 5.1 +/- 2.3 hr ) was significantly shorter than in the other three groups ( II -16.6 +/- 4.9 hr ; III - 17.2 +/- 5.5 hr ; IV - 17.0 +/- 5.8 hr ; P < 0.05 ) . Total analgesic ( paracetamol ) consumption was significantly more in Group I ( 697.6 +/- 240.7 mg ) than in the groups receiving caudal neostigmine ( II - 248.0 +/- 178.4 ; III - 270.2 +/- 180.8 and IV -230.6 +/- 166.9 mg ; P < 0.05 ) . Groups II , III and IV were comparable with regards to duration of postoperative analgesia and total analgesic consumption ( P > 0.05 ) . Incidence of nausea and vomiting were comparable in all four groups . No significant alteration in vital signs or any other adverse effects were observed . CONCLUSIONS Caudal neostigmine ( 2 , 3 and 4 microg.kg ( -1 ) ) with bupivacaine produces a dose-independent analgesic effect ( approximately 16-17 hr ) in children as compared to those receiving caudal bupivacaine alone ( approximately five hours ) and a reduction in postoperative rescue analgesic consumption without increasing the incidence of adverse effects .
18266
Intervention_Pharmacological
Caudal neostigmine with bupivacaine
18267
Intervention_Pharmacological
caudal neostigmine with plain bupivacaine
18268
Intervention_Pharmacological
only caudal
18269
Intervention_Pharmacological
plain bupivacaine
18270
Intervention_Pharmacological
0.25 % plain bupivacaine 0.5 mL.kg ( -1 ) with neostigmine
18271
Intervention_Pharmacological
( paracetamol )
18272
Intervention_Pharmacological
neostigmine
18273
Intervention_Pharmacological
Caudal neostigmine
18274
Intervention_Pharmacological
bupivacaine
18275
Intervention_Pharmacological
bupivacaine
18276
Outcome_Other
evaluate
18277
Outcome_Other
analgesic efficacy and duration
18278
Outcome_Pain
Postoperative pain
18279
Outcome_Pain
objective pain score .
18280
Outcome_Physical
Blood pressure , heart rate , oxygen saturation , total amount of analgesic consumed
18281
Outcome_Adverse-effects
adverse effects
18282
Outcome_Pain
duration of postoperative analgesia
18283
Outcome_Physical
Total analgesic ( paracetamol ) consumption
18284
Outcome_Other
duration of postoperative analgesia and total analgesic consumption
18285
Outcome_Adverse-effects
nausea
18286
Outcome_Adverse-effects
vomiting
18287
Outcome_Adverse-effects
vital signs
18288
Outcome_Physical
analgesic effect
18289
Outcome_Physical
postoperative rescue analgesic consumption
18290
Outcome_Adverse-effects
adverse effects
18291
Participant_Age
children
18292
Participant_Condition
.
18293
Participant_Age
children
18294
Participant_Condition
undergoing genito-urinary surgery .
18295
Participant_Sample-size
80
18296
Participant_Age
two to eight