A Prospective Observational Study – Epidural Catheter Insertion Site and Adequacy of Post-Operative Pain Relief in Children undergoing Thoracic and Upper Abdominal Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 10
Abstract
Background and aims: Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, rapid weaning from ventilators, lowered circulating stress hormone levels. Precise placement of epidural catheters ensures selective blockade of dermatomes affected by surgical procedure, allowing reduction of doses of local anaesthetics and additional analgesics. The aim of the study was to analyse efficacy of epidural analgesia in relation to distance between catheter placement and site of surgery. Methods: This was prospective observational study carried out for a year, total of 44 paediatric patients who underwent thoracoabdominal surgery under general anaesthesia with epidural analgesia were considered and studied for general practice in our institute for epidural catheter placement, efficacy of epidural analgesia in relation to distance between catheter placement and site of surgery, complications of epidural catheter placement.Data were expressed as means (with standard deviations) and percentages (for categorical data). Unpaired t test and chi square test were used to compare continuous and categorical data respectively. Results: The total volume of local anaesthetic required in first 24 hrs postoperative in congruent group was 6.67±2.56ml/kg as compared to 8.60±2.938ml/kg incongruent group (p=0.025). In congruent group 16% of children required additional analgesic as compared to incongruent group where 36.84% of children required additional analgesics. Conclusion: Our study shows that putting the epidural catheter congruent to surgical incision required less of volume of local anaesthetic and additional analgesics and should be practiced preferably.
Authors and Affiliations
Afroz Shahana M. Khan
Keywords
Related Articles
- EP ID EP548133
- DOI 10.21088/ijaa.2349.8471.51018.4
- Views 62
- Downloads 0
Evaluation of Pain and Phlebitis using Topical Heparin Solution at Central and Peripheral venous Punctures
Background: Phlebitis refers to the inflammation of a vein which can occur after repetitive intravenous injections through peripheral or central venous cannulation. Various preventive modalities are available but, none h...
A Comparision between Femoral Nerve Block, Intravenous Fentanyl and Ketamine as Preemptive Analgesics in Lower Limb Fractures
Background: Spinal & combined spinal epidural anaesthesia are the preferred techniques for facilitation of surgical fixation of the fractures of the lower limb. Extreme pain does not allow ideal positioning for these pro...
Impact of Care Bundle on Prevention of Ventilator Associated Pneumonia in an Adult Intensive Care Unit at a Rural Tertiary Teaching Hospital
Objectives: To evaluate the incidence of ventilator associated pneumonia (VAP) before and after implementation of VAP Care bundle and to correlate incidence of VAP with Care bundle compliance. Methods: This is a prospect...
Evaluation of Ultrasound Guided Transversus Abdominis Plane Block for Post Operative Analgesia after Lower Segment Caeseraen Section
Background: transversus abdominis plane (TAP) block as an effective chunk of post operative multi modal analgesia for lower abdominal surgeries. Objective: to evaluate the effectiveness of TAP block as a post-operative a...
Efficacy of Dexmedetomidine Compared to Clonidine as an Adjuvant to Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block
Background: Regional block has evolved with passage of time from being a blind process to the use of ultrasound giving an “eye” to the process. Evolution of technology and pharmacology has helped anesthesiologist in many...