British Journal of Anaesthesia, Vol 79, Issue 3 293-296, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia
D. P. Prosser, A. Davis, P. D. Booker and A. Murray
Ninety boys, aged 13-53 months, undergoing repair of hypospadias, were
allocated randomly to receive 0.8 ml kg-1 of one of three solutions into
the caudal extradural space: group B received bupivacaine 2 mg kg- 1, group
T received tramadol 2 mg kg-1 in 0.9% saline and group BT a mixture of
both. Postoperative pain was assessed hourly for 12 h after injection using
a modified TPPPS pain score and additional analgesia was administered to
those children whose pain scores were > 3/10. Nine patients (30%) in
group T required additional analgesia within 1 h of surgery compared with
only two (6.7%) and three (10%) patients in groups B and BT, respectively
(P = 0.04). Mean duration before additional analgesia was required in the
remaining patients was 9.3 (SD 3.0) h in group B, 10.7 (2.2) h in group T
and 10.5 (2.0) h in group BT (P > 0.20). There were no significant
differences between the groups in mean ventilatory frequency, sedation
scores, incidence of emesis, facial flushing or pruritus. We conclude that
caudal tramadol had a slow onset of action and that the addition of
tramadol to bupivacaine, when both drugs were administered caudally, did
not significantly prolong the duration of action of bupivacaine.
CLINICAL INVESTIGATIONS
Caudal tramadol for postoperative analgesia in pediatric hypospadias surgery
Department of Anaesthesia, Royal Liverpool Children's NHS Trust, Eaton Road, Liverpool L12 2AP
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