| ||||||||||||||
|
|
|||||||||||||
Department of Anesthesiology, Cairo University, Egypt
Address correspondence and reprint requests to Mohamed Abdulatif, MD, PO Box 147, Panorama October 11811, Nasr City, Cairo, Egypt. Address e-mail to abdulatif{at}hotmail.com
In a randomized, double-blinded study, we examined the analgesic efficacy of caudal neostigmine, bupivacaine, or a mixture of both drugs in 60 children. After the induction of general anesthesia, children were allocated randomly into three groups (n = 20) to receive a caudal injection of either 0.25% bupivacaine 1 mL/kg, with or without neostigmine 2 µg/kg, or neostigmine 2 µg/kg in normal saline 1 mL/kg. Intraoperatively, children receiving caudal bupivacaine or a bupivacaine/neostigmine mixture maintained hemodynamic stability, required less inhaled anesthetics, and had a shorter recovery time compared with the caudal neostigmine alone. Postoperatively, the caudal bupivacaine/neostigmine mixture resulted in superior analgesia compared with the other two groups. Recovery to first rescue analgesic times were (mean ± SD) 22.8 ± 2.9 h, 8.1 ± 5.9 h, and 5.2 ± 2.1 h in the bupivacaine/neostigmine, bupivacaine, and neostigmine groups, respectively (P < 0.001). In addition, the bupivacaine and neostigmine groups received more doses of paracetamol than the bupivacaine/neostigmine group to maintain adequate analgesia in the first 24 postoperative h. Postoperative vomiting occurred in 25%, 10%, and 30% in the caudal bupivacaine/neostigmine, bupivacaine, and neostigmine groups, respectively (P < 0.01). We conclude that caudal neostigmine 2 µg/kg provides postoperative analgesia comparable to caudal bupivacaine in children undergoing hypospadias repair surgery.
IMPLICATIONS: Caudal neostigmine 2 µg/kg provides postoperative analgesia comparable to caudal bupivacaine in children undergoing hypospadias repair surgery. Co-administration of the two drugs is associated with extended postoperative analgesia and reduced need for supplementary analgesics.
This article has been cited by other articles:
![]() |
N. Almenrader, M. Passariello, R. Mahajan, Y.K. Batra, S. Kumar, and P.A. Lonnqvist Adjuncts to caudal blockade in children. Br. J. Anaesth., March 1, 2006; 96(3): 401 - 402. [Full Text] [PDF] |
||||
![]() |
P. F. White The Changing Role of Non-Opioid Analgesic Techniques in the Management of Postoperative Pain Anesth. Analg., November 1, 2005; 101(5S_Suppl): S5 - 22. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. A. Lonnqvist Adjuncts to caudal block in children--Quo vadis? Br. J. Anaesth., October 1, 2005; 95(4): 431 - 433. [Full Text] [PDF] |
||||
![]() |
T. G. Hansen, S. W. Henneberg, S. Walther-Larsen, J. Lund, and M. Hansen Caudal bupivacaine supplemented with caudal or intravenous clonidine in children undergoing hypospadias repair: a double-blind study Br. J. Anaesth., February 1, 2004; 92(2): 223 - 227. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Mahajan, D. A. H. de Beer, and M. L. Thomas Caudal neostigmine in children Br. J. Anaesth., November 1, 2003; 91(5): 761 - 762. [Full Text] [PDF] |
||||
|