Post Operative Pain
Conditions
Brief summary
The aim of this study is to compare the duration of analgesia, sedation, and intra and postoperative hemodynamics. This drug is recently available in Pakistan. To the best of our knowledge, no published data is available in this respect in Pakistan, so this study would in turn help to fill the gap in knowledge in low-resource settings/emerging economy.
Detailed description
Postoperative pain is an annoying subjective sensation for both children and their parents. Almost 80% of the patients undergoing surgery experience postoperative pain, and 80% of them reported moderate to severe pain intensity. Management of postoperative pain has become a major concern in pediatrics. Results of many studies in different countries show that postoperative pain in children is inadequate. Lee et al showed that one of the main reasons for inadequate treatment of postoperative pain in children is difficulties with pain assessment and concerns related to the side effects of opioid analgesics. The regional anesthetic technique significantly decreases postoperative pain and systemic analgesic requirements. Caudal block, usually combined with general anesthetic technique is one of the most popular, reliable, and safe anesthesia techniques for abdominal and lower limb surgeries in children but the main disadvantage of caudal analgesia is the short duration of action after a single injection. Bupivacaine is a long-acting, reliable local anesthetic agent that is used as a caudal analgesic, but different auxiliary agents need to be co-administered to improve its analgesic efficiency. Various additives used in the past to increase the pain-free period postoperatively and to decrease the analgesic requirement such as midazolam neostigmine, ketamine, clonidine, and dexmedetomidine. Dexmedetomidine is a potent and highly selective alpha 2 adrenergic agonists that has been described as safe and effective in many anesthetic applications and analgesic techniques. In contrast to other agents, it has sympatholytic, analgesic, and sedative effects, and is randomly free from side effects except for manageable hypotension and bradycardia.
Interventions
Bupivacaine Hydrochloride 0.25% Injection Dose: 1mL/kg (milliliter per kilogram body weight)
DRUGBupivacaine Hydrochloride 0.25% Injection plus Dexmedetomidine 1 microgram/kg body weight
Bupivacaine HCL 0.25% Injection plus Dexmedetomidine 1micro/kg Dose: 1 mL/kg (milliliter per kilogram body weight)
Sponsors
Sindh Institute of Urology and Transplantation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
comparative study
Eligibility
Sex/Gender
ALL
Age
2 Months to 7 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA 1 & 2 * elective per-urethral cystolithotripsy
Exclusion criteria
* History of developmental delay or mental retardation * Known or suspected coagulopathy * Known allergy to any of the study drugs * Any signs of infection at the site of the proposed caudal block * Any caudal anatomical deformity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post operative Pain | 24 hour post operatively | * face, legs, activity, cry, and consolability (FLACC) behavioral pain scale * Each category is scored on the 0-2 scale which results in a total score of 0-10. * Assessment of FLACC Pain Score: * 0 = Relaxed and comfortable * 1-3 = Mild discomfort * 4-6 = Moderate pain * 7-10 = Severe discomfort/pain |
Countries
Pakistan
Outcome results
None listed