Neostigmine as an Adjuvant to Caudal Bupivacaine in Paediatric Population
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 5
Abstract
ABSTRACT Introduction: Postoperative pain in children is very distressing for the parents as well as the Anaesthesiologist involved. Pain assessment in children has its limitations. Caudal analgesia is the most popular central neuraxial block in paediatric age group for perioperative analgesia and attenuation of stress response particularly in infra umbilical surgeries. Use of adjuvants to local anaesthetic agents enhance the duration of analgesia. Aim: To assess the efficacy of Neostigmine as an adjuvant to Bupivacaine in Caudal blocks in paediatric inguinal herniotomies. Materials and Methods: This was a prospective, double blinded randomised clinical study. Forty ASA1 children in the age group, 2-6 years, were randomly allocated to two groups (n=20 each). The 1st group (Group B) received caudal injection of 0.25% Bupivacaine 1 mL/kg plus 1 mL NS after induction of general anaesthesia. The 2nd group (Group BN) received caudal injection of 0.25% Bupivacaine 1 mL/kg plus Neostigmine 2 mcg/kg made up in 1 mL NS after administration of general anaesthesia. Both groups received IV Ondansetron 0.1 mg/kg towards the end of the surgery. The pain scores, haemodynamic parameters, requirement of analgesics, duration of sedation and motor block, time to first micturition and incidence of nausea and vomiting were studied. The quantitative data was statistically analysed using Student’s t-test. Results: Demographics were similar and haemodynamics were stable in both groups. Better analgesia was noted in Group BN compared to Group B (15.16 hours vs 6.52 hours) with more post op analgesic requirement in group B compared to Group BN. There was no incidence of nausea and vomiting in both groups. Conclusion: Addition of Neostigmine as adjuvant to Bupivacaine in Caudal block resulted in superior analgesia in post paediatric inguinal herniotomy patients with lesser requirement of postop analgesics. Use of IV Ondansetron towards end of surgery prevented postoperative nausea and vomiting.
Authors and Affiliations
Manjit George, Sheela Prabhakaran, Maya Gomathyamma
Keywords
Related Articles
- EP ID EP524065
- DOI 10.7860/JCDR/2018/34912.11558
- Views 73
- Downloads 0
First Detection and Characterization of Streptococcus dentapri from Caries Active Subject
Introduction: Mutans streptococci (MS) are a group of oral bacteria generally regarded as the principal agents in the pathogenesis of dental caries. Aim: The study was aimed to characterize S. dentapri based on phylogene...
Evaluation of Acute Oral Toxicity of Ethanol Leaves Extract of Catharanthus roseus in Wistar Albino Rats
Introduction: Herbal drugs have gained importance globally in the treatment of various diseases. Catharanthus roseus is traditionally used as an anti diabetic and anti cancer drug. To the best of our knowledge limited da...
Accuracy and Precision of Measured Blood Sugar Values by Three Glucometers Compared to the Standard Technique
Introduction: The prevalence of diabetes mellitus has magnified, globally. Being cost effective and user friendly, using the glucometer systems has become more widespread. However, despite their advantages, there are con...
Application of C-Arm for Intra Operative Radiographic Support in Oral and Maxillofacial Surgical Procedures Under General Anaesthesia
Letter to Editor
Knowledge and Perception about Pharmacovigilance among Pharmacy Students of Universities in Sana’a Yemen
Introduction: Pharmacists in community or hospital setting play a key role in reporting Adverse Drug Reaction (ADRs) during practice. Under reporting is considered as a profession malpractice worldwide. Aim: To determine...