A study to compare caudal levobupivacaine, tramadol and a combination of both in paediatric inguinal hernia surgeries

Neelam Dogra, Rajat Dadheech, Mahipal Dhaka, Anupama Gupta, Neelam Dogra, Rajat Dadheech, Mahipal Dhaka, Anupama Gupta

Abstract

Background and aims: Caudal block is a safe and simple method of pain relief in young children with the drawback of a short duration of analgesia which can be overcome by adding various adjuvants to the injected local anaesthetic. We compared the effects of caudal levobupivacaine, tramadol and a combination of both in paediatric patients undergoing inguinal herniotomy.

Methods: A total of 78 children aged 1-7 years, planned for inguinal herniotomy were randomly allocated into three groups. Group L received levobupivacaine 0.125% 1 ml/kg, Group T received tramadol 1.5 mg/kg in 0.9% NS and Group LT 1 ml/kg of 0.125% levobupivacaine with 1.5 mg/kg tramadol caudally. The primary outcome was the duration of analgesia. Rescue analgesic doses required, the duration of motor blockade and adverse effects were recorded for 12 h post-operatively. Data was analysed by analysis of variance test, Kruskal-Wallis and Chi-square tests.

Results: All groups were comparable with regard to age, sex and duration of surgery. No motor block was observed in any of the patients. The mean duration of analgesia in Group L was 321.46 ± 84.76 min, in Group T was 565.19 ± 107.08 min, and in Group LT was 720 min (P < 0.001). The requirement for rescue analgesia in tramadol group was significantly less as compared to levobupivacaine group. Sedation scores and adverse effects were comparable among all groups.

Conclusion: Addition of tramadol to caudal levobupivacaine significantly increased the duration of postoperative analgesia.

Keywords: Caudal block; inguinal herniotomy; levobupivacaine; tramadol.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials flow diagram showing patient progress through the study phases
Figure 2
Figure 2
Mean duration of analgesia
Figure 3
Figure 3
Rescue analgesia requirement

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