title: Caudal bupivacaine vs bupivacaine plus tramadol in post-operative analgesia in children.
abstract: BACKGROUND
  Caudal analgesia with bupivacaine is used commonly for pain relief in children and extradural administration of tramadol seemed to be a safe method of analgesia. The aim of the study is to compare the analgesic efficacy of caudal bupivacaine and bupivacaine and tramadol mixture for postoperative analgesia and to observe for side effects.
  
  
  METHODS
  Forty children, aged between 1- 6 years undergoing infra umbilical surgeries were selected for this randomized, control trial. They were randomly divided into two groups. Group A (n = 20) received 0.5 ml/kg of 0.25 % bupivacaine and Group B (n = 20) received 0.5 ml/kg of 0.25 % bupivacaine with 1 mg/kg of tramadol as a single shot caudal block. In the postoperative period heart rate, respiratory rate, pain score, recovery to first analgesic time, total number of analgesics required in 24 hours and side effects were noted and analyzed.
  
  
  RESULTS
  It was observed that the mean duration of pain relief was significantly longer in Group B (8.8 hrs Vs 7 hrs). Nausea and vomiting was observed in 25% of the patients in group B and 20 % of the patients in group A. None of the patients in both the groups had complication like motor weakness, urinary retention in the postoperative period.
  
  
  CONCLUSIONS
  The addition of tramadol to bupivacaine in the caudal analgesic technique provides longer analgesia and lesser need for rescue analgesic in the postoperative period compared to bupivacaine.
authors.affiliation: Department of Anesthesiology, Dhulikhel Hospital, Nepal Health Research Council Hospital, Dhulikhel, Kavre, Nepal. drsantosh_shrestha@yahoo.com
authors.forename: S K
authors.initials: SK
authors.lastname: Shrestha
authors.forename: B
authors.initials: B
authors.lastname: Bhattarai
mesh_terms: D000763:Anesthesia, Caudal / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy*; D011183:Postoperative Complications; D013997:Time Factors; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000779:Anesthetics, Local; D014147:Tramadol; D002045:Bupivacaine