A Comparative Clinical Study between Clonidine and Tramadol with Bupivacaine in Caudal Epidural for Postoperative Analgesia in Pediatric Surgery

CONTEXT: Adjuvants to bupivacaine for single shot caudal block in children. AIMS: This study entitled was conducted to compare the effects of addition of tramadol to bupivacaine over addition of clonidine to bupivacaine as a single shot caudal block in children. SETTINGS AND DESIGN: Sixty children of ASA grade I and II in the age group of 2-12 years coming for various infra-umbilical surgeries were included. MATERIALS AND METHODS: They were divided into two groups of 30 each. Group BC received caudal bupivacaine 0.25% 0.5ml/kg with clonidine 2 mcg/kg Group BT received caudal bupivacaine 0.25% 0.5 ml/kg with tramadol 2 mg/kg. The main parameters studied were hemodynamic changes, duration of post-operative analgesia and incidence of adverse effects. STATISTICAL ANALYSIS USED: The results of continuous variables are given as mean ± SD and proportion as percentage. The difference between the two groups was assessed by student's – t test and chi-square test RESULTS: The mean duration of post-operative analgesia in group BT was statistically significant (P <0.001), reducing the requirement of analgesics in group BT. There was no difference in sedation score, nausea, vomiting, urinary retention. CONCLUSIONS: The present study demonstrated that caudal administration of bupivacaine 0.25% 0.5 ml/kg with tramadol 2 mg/kg resulted in superior analgesia with longer duration of action and reduced requirement of analgesics in first 24 hours postoperatively when compared with 0.25% bupivacaine 0.5 ml/kg with clonidine 2 mcg/kg.