Comparison of Caudal Block and Local Bupivacaine in Children for Post-operative Pain

Abstract

Objective: To compare efficacy of caudal block with Bupivacaine and local infiltration of wound with Bupivacaine in children after inguinal herniotomy so as to replace narcotic analgesics with other alternatives particularly in daycare surgeries.
Methods: Present randomized controlled trial conducted in Paediatric Surgery Unit, Services Hospital, Lahore for a period one year. Patients were randomly divided in two groups by lottery method. Group A: Caudal group, Group B: Local Bupivacaine. Postoperatively patients were assessed for pain using Wong Bakers Faces pain scale. The intensity of the pain was recorded at 0, 1, 2, 4, 6 and 8 hours. Statistical analysis was done using SPSS version 20.
Results: A total of 150 patients were included in the study, fulfilling the inclusion and exclusion criteria. In group A 12 while 9 patients while in group B 9 were postponed due to low hemoglobin or other causes like respiratory tract infection. Remaining patients who completed the study were 63 in group A and 66 in group B. P value was significant (<0.005) in both groups at 0 hour but at 1, 2,4
and 8 hour it was not significant. Mean pain scores in group A were less than group B at all readings. In group A, 21 patients (33.33 %) needed rescue analgesic while in group B, 24 patients (36.33%) needed rescue analgesic (P=0.698). Mean time for requirement of rescue analgesic was 4.66 ± 2.105hours in group A while 5.000±2.043hours in group B (P=0.169).
Conclusions: Present study showed caudal with bupivacaine is slightly superior, however both techniques are effective for post operative pain control in children after inguinal herniotomy.