Pre-emptive analgesia : comparing caudal analgesia using bupivacaine alone and bupivacaine with morphine in hip surgery in children

الملخص EN

Objective: Pre-emptive analgesia is superior to other types of analgesia for post-operative pain relief.

We compared two methods of caudal analgesia for hip surgery over a one-year period between July 1998 and July 1999.

Methods: Ninety patients undergoing hip surgery under general anesthesia were divided into two groups.

In group one, 44 children were given caudal analgesia using 0.25 % bupivacaine (0.5 ml / kg) with morphine (50 fig / kg), and in group two, 46 children were given caudal analgesia using 0.25 % bupivacaine (0.5 ml / kg) alone.

The pain scores, respiratory rates, analgesic requirements and side effects were observed for 24 hours post-operatively.

Urine retention by the first passage of urine was also monitored.

Results : There was no statistically significant difference between the two groups with respect to age, weight and duration of surgery.

The pain scores in the first post¬operative hour were significantly lower for the bupivacaine plus morphine group compared to the bupivacaine alone group (p < 0.05).

The respiratory rates were significantly lower in the bupivacaine plus morphine group at 15 and 30 minutes post-operatively only.

There was no statistically significant difference between the two groups with respect to other side effect like urine retention, nausea, vomiting and pruritus.

Conclusion: Pre-operative analgesia is effective and safe by the caudal route, but is more efficient with a mixture of local anesthetic and an opiate.