Postoperative Analgesia in Children- Comparative Study between Caudal Bupivacaine and Bupivacaine plus Tramadol

SUMMARY: Thirty children, ASAI-II, aged between 2yrs-5yrs, undergoing sub umbilical operation (inguinal and penile surgery) were selected for this double blind study. They were randomly divided in two groups, group A and group B. Group A(n=15) received 0.25%bupivacaine 0.5ml.kg(−1) and Group B (n=15) received 0.25% bupivaeaine 0.5ml.kg(−1) and tramadol 2mg.kg(−1) as single shot caudal block. Postoperative pain was assessed by a modified TPPPS (Toddler-Preschool Postoperative Pain Scale) and analgesic given only when the score was more than 3. In the first 24 hrs it was observed that the mean duration of time interval between the caudal block and first dose of analgesic was significantly long(9.1hrs) in Group B as compared to Group A (6.3hrs) which was much shorter(p<0.01). There was no significant haemodynamie changes, motor weakness or respiratory depression in both groups. This study concluded that addition of tramadol 2mg.kg(−1) to caudal 0.25% bupivacaine 0.5ml.kg(−1) significantly prolong the duration of postoperative analgesia in children without producing much adverse effects.