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- Title
Neostigmine as an adjunct to Bupivacaine, for caudal block in burned children, undergoing skin grafting of the lower extremities.
- Authors
Gupta, Pramod; Grace, Amy
- Abstract
In this study we compared the duration and intensity of caudal blockade when two different concentrations of bupivacaine were used, along with a fixed dose of neostigmine. Fifty burned pediatric patients undergoing skin grafting of the lower extremeties were prospectively randomized to receive caudal analgesia with either 0.125% or 0.25% bupivacaine, along with neostigmine @ 6mcg/kg [total volume of the drug was 0.5ml/kg]. Both the groups also received intravenous ondansetron as premedication. The two groups were then assessed for duration and efficacy of postoperative analgesia and any postoperative complications. Both the groups received good pain relief. (p<0.05) The duration of pain relief was however noted to be higher in the 0.25% group, Group B.25N with p=0.000 and Group B.125N with p<0.05 although the degree of pain relief was more or less the same. Rescue analgesia was once in Group B.25N as compared to thrice in Group B.125N in 24hrs. Patients were also found to be more haemodynamically stable postoperatively in the 0.25% group [Group B.25N with p<0.003,0.005,0.004,0.003 at 4hrs,8hrs,12hrs,24hrs post-operatively than Group B.125N although intra-operatively no difference was noted (p >0.05). The two groups were also comparable in terms of sedation scoring [0/4 in both groups, with p>0.05], and no complications was noted with any patients of either group. Implications: Neostigmine as an additive to caudal bupivacaine, prolongs the duration of the block without any adverse effect. Patients receiving 0.25% bupivacaine were hemodynamically more stable and more active postoperatively and premedication with an ondansetron prevents the occurrence of post-operative emesis.
- Subjects
SKIN blood-vessels; ABNORMALITIES in the anatomical extremities; SURGICAL complications; POSTOPERATIVE nausea &; vomiting; BURN patients; ONDANSETRON; DISEASES
- Publication
Anestesia Pediatrica e Neonatale, 2011, Vol 9, Issue 1, p1
- ISSN
1723-0330
- Publication type
Article