Chimaobi T Nnaji1, Bisola Onajin-Obembe2, Longinus Ebirim2. 1. Department of Anesthesiology, University of Port Harcourt Teaching Hospital, Rivers State, - Nigeria. Electronic address: chymaoby@yahoo.com. 2. Department of Anesthesiology, University of Port Harcourt Teaching Hospital, Rivers State, - Nigeria.
Abstract
BACKGROUND:Postoperative pain is a common complaint in day-case inguinal herniotomy, thus there is a need to provide effective analgesia. This study compared the postoperative analgesic effects of the combinations of caudal-bupivacaine and rectal diclofenac with caudal-bupivacaine and rectal-paracetamol in children scheduled for daycase inguinal-herniotomy. METHODS:Ninety children of ASA I scheduled for elective day-case inguinal-herniotomy were randomly assigned into Group A (1ml/kg of 0.25% caudal-bupivacaine and 1mg/kg rectal-diclofenac), Group B (1ml/kg of 0.25% caudal-bupivacaine and 30mg/kg rectal paracetamol) and Group C (1ml/kg of 0.25% caudal-bupivacaine). The duration of analgesia, pain scores, postoperative analgesic consumption and side effects were assessed and recorded. Data collected was analyzed with the statistical package for social sciences 17 for windows. RESULTS:Eighty-seven children completed the study, and it was found that the duration of analgesia was prolonged in Group A compared to Groups B and C (p<0.01). CONCLUSION:Caudal-bupivacaine and rectal-diclofenac combination provides a more prolonged postoperative analgesia, and lower pain score compared to caudal-bupivacaine and rectal-paracetamol combination or caudal-bupivacaine alone. LEVEL OF EVIDENCE: Level 1 evidence treatment study. Randomized controlled trials with adequate statistical power to detect differences (narrow confidence intervals) and follow up >80%.
RCT Entities:
BACKGROUND:Postoperative pain is a common complaint in day-case inguinal herniotomy, thus there is a need to provide effective analgesia. This study compared the postoperative analgesic effects of the combinations of caudal-bupivacaine and rectal diclofenac with caudal-bupivacaine and rectal-paracetamol in children scheduled for daycase inguinal-herniotomy. METHODS: Ninety children of ASA I scheduled for elective day-case inguinal-herniotomy were randomly assigned into Group A (1ml/kg of 0.25% caudal-bupivacaine and 1mg/kg rectal-diclofenac), Group B (1ml/kg of 0.25% caudal-bupivacaine and 30mg/kg rectal paracetamol) and Group C (1ml/kg of 0.25% caudal-bupivacaine). The duration of analgesia, pain scores, postoperative analgesic consumption and side effects were assessed and recorded. Data collected was analyzed with the statistical package for social sciences 17 for windows. RESULTS: Eighty-seven children completed the study, and it was found that the duration of analgesia was prolonged in Group A compared to Groups B and C (p<0.01). CONCLUSION:Caudal-bupivacaine and rectal-diclofenac combination provides a more prolonged postoperative analgesia, and lower pain score compared to caudal-bupivacaine and rectal-paracetamol combination or caudal-bupivacaine alone. LEVEL OF EVIDENCE: Level 1 evidence treatment study. Randomized controlled trials with adequate statistical power to detect differences (narrow confidence intervals) and follow up >80%.