Perioperative Safety and Efficacy of Pre-Surgical Multimodal Analgesia versus Intravenous Opioids in Children Undergoing Infraumbilical Urogenital Surgery

Academia Anesthesiologica International

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Title Perioperative Safety and Efficacy of Pre-Surgical Multimodal Analgesia versus Intravenous Opioids in Children Undergoing Infraumbilical Urogenital Surgery
 
Creator S Jani Noopur
P Butala Bina
 
Subject Multimodal analgesia
caudal block
clonidine
 
Description Background: MMA (multimodal analgesia) alleviates pain through blockade of multiple nociceptive and inflammatory pain receptors along the pain pathway. Thus it maximizes pain control and minimizes drug induced adverse effects especially of opioids. We studied safety and efficacy of MMA comprising anti-inflammatory, local anaesthetics and alpha 2 agonist (in caudal block) against conventional opioid analgesia in children undergoing infra-umbilical urogenital surgery. Subjects and Methods: A randomized, prospective, single blind study was conducted in 40 patients aged between 1-8 years. After pre-medication, patients were given general anaesthesia with controlled ventilation via LMA. In Multimodal analgesia group, pre-surgical caudal block was given with Inj.Bupivacaine 0.25 %( 1ml/kg) +Inj.Clonidine (1mcg/kg).Paracetamol 30mg/kg inserted per rectally. In Opioid group, pre-surgical intravenous Fentanyl (2 mcg/kg) was given. Intra-operative fentanyl requirement, hemodynamic parameters ,sevoflurane dial concentration, side effects like nausea , vomiting, respiratory depression, emergence agitation, excessive sedation and post-operative fentanyl requirement(0.5mcg/kg, on demand/FLACC score>4 at 1,4,6 hrs) were noted. Patients were observed for 6 hrs in postoperative period. Result: We found significant increase in postoperative analgesic requirement in opioid group (18/20; p<0.001), while intra-operative opioid requirement was stastically insignificant between both the groups (p=0.17).Though linear decreasing trend in intraoperative inhalational agent requirement was observed in MMA group. Both the groups were comparable in terms of adverse effects. Conclusion: Presurgical MMA with caudal block and rectal paracetamol is safe and efficacious in children undergoing infraumbilical surgery.
 
Publisher Society for Health Care & Research Development
 
Date 2021-06-05
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
application/xml
text/html
application/epub+zip
 
Identifier https://aijournals.com/index.php/aan/article/view/1952
 
Source Academia Anesthesiologica International; Vol 6 No 1 (2021): January-June 2021; 85-90
2456-7388
2617-5479
 
Language eng
 
Relation https://aijournals.com/index.php/aan/article/view/1952/2287
https://aijournals.com/index.php/aan/article/view/1952/2288
https://aijournals.com/index.php/aan/article/view/1952/2289
https://aijournals.com/index.php/aan/article/view/1952/2290
 
Rights Copyright (c) 2021 Author
https://creativecommons.org/licenses/by/4.0/
 

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