Comparison of caudal bupivacaine and intravenous ketorolac tromethamine for post-operative analgesia efficacy in children Çocuklarda kaudal yolla uygulanan bupivakain ile i̇ntravenöz ketorolak tromethamin'in postoperatif analjezik etkinliǧinin karşilaştirilmasi
Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, cilt.32, sa.6, ss.467-473, 2004 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 6
- Basım Tarihi: 2004
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.467-473
- Anahtar Kelimeler: Bupivacaine, Caudal anaesthesia, Ketorolac tromethamine, Pain, Pediatric
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
The optimal methods to achieve pain relief after outpatient surgery in children is unknown. We aimed to compare the analgesic efficacy and the adverse effects between caudal anaesthesia that was performed with bupivacaine and adrenaline, with intravenous ketorolae. With parental consent and ethical committee approval, 42 children aged 2-5 years (ASA I-II) undergoing outpatient surgery were enrolled in this prospective, randomized, single blinded study. All children received midazolam (0.5 mg kg-1) orally 30-40 min prior to surgery. Anaesthesia was induced by inhalation with nitrous oxide and sevoflurane, and was maintained with nitrous oxide and sevoflurane. Patients were randomly assigned to receive caudal anaesthesia (Group A: 1 mL kg -1 of mixture of 0.2% bupivacaine with 1/200000 adrenaline) or intravenous ketorolae (Group K:1 mg kg-1) immediately after intubation. Postoperative analgesia and sedation were evaluated using objective pain score and three-point scale, respectively. Postoperative measurements including objective pain score, sedation scores, blood presure, heart rate, peripheral arterial oxygen saturation and side effects were recorded for 4 hours in the recovery area. Thereafter, parents assessed pain with objective pain score at home. Parents were contacted hourly by telephone for 20 hours after discharge, objective pain score was lower in group K compared with the group A after the 6th postoperative hour (p<0.01). OPS was also lower in the 6th and the 12-24th hours in group K and lower in 21st hour in group A when compared with the first hour (p<0.05). The duration of analgesia was 6.3 ± 3.3 h in group A, 6.7±4.3 h in group K (p>0.05). Sedation score was lower in group K compared with group A during the first 2 hours, postoperatively. Moreover, the sedation score was lower in the 3rd and 4th hours in group K and A when compared with the first hour (p<0.05). We concluded that the use of intravenous ketorolac in pediatric patients can be effective, and provides equal postoperative pain relief with less sedation.