European Journal of Cardiovascular Medicine

Background: The goal is to reduce or eliminate perioperative pain with as few adverse effects as possible. The mode of anaesthesia that has been proven to be safe and effective in children is regional. In addition to extending analgesia to the postoperative period with minimal sedation (2), the use of inhalational and intravenous analgesics can be reduced. In childern caudal epidural is the regional block infra-umbilical procedures. Objectives:This study was aimed at comparing Bupivacaine 0.125 % (1ml/kg) alone against Bupivacaine 0.125 % (1ml/kg) plus Fentanyl 0.5 μg/kg as a caudal block administered via single bolus in infra-umbilical procedures in children aged 1 to 8 years.Hemodynamic alterations, ie heart rate and blood pressure., and Duration of post operative analgesia after and Adverse reactions are the parameters noted  Material & Methods:  Study Design: A prospective, randomized, comparative study. Study area: Department of Anaesthesia and Critical care, Government Medical college ,Srikakulam ,AP.Study Period: 1 year.  Study population: children, of both gender, posted for infraumbilical procedures of various types. Sample size: study consisted a total of 60 cases. Sampling method: Simple random method.A general, systemic examination, including the airway and spine, was done on the day of surgery also. Vital parameters such as systolic blood pressure, respiratory rate and pulse rate were noted. In addition, investigations such as blood and urine tests, bleeding and clotting times, a chest x- ray if necessary, and viral tests (HIV & HBsAg) were done. Informative and written consent was obtained from the parent. Prior to surgery, restriction was advised for solid foods for 6 hours, milk for 4-5 hours and clear fluids for 2-3 hours. All children were given 1 mg/kg of Promethazine syrup the night before the scheduled operation. Results: The mean duration of analgesia at various time intervals in both the groups was statistically significant. The mean duration of analgesia in the B group (0.125% Bupivacaine) is 5.2 ± 0.85 hrs, the mean duration of analgesia in the BF group (0.125 % Bupivacaine + 0.5 mc/kg Fenyanyl) is 10.8 ± 1.24 hrs. This duration of analgesia is statistically significant as detected by using t test (p = 0.03, <0.05) Conclusion: The present study demonstrated that caudal epidural block with Bupivacaine 0.125% (1ml/kg) plus Fentanyl (0.5 mcg/kg) resulted in analgesia of longer duration and postoperative analgesia when compared with 0.125% Bupivacaine (1ml/kg) alone, with no significant difference in the hemodynamic parameters and the occurrence of side effects.