A comparative study of caudal epidural anaesthesia versus general anaesthesia for lower abdominal and lower limb surgery in paediatric patients

Background: Our aim is to compare caudal epidural versus general anaesthesia in paediatric patients and to check safety and efficacy of caudal epidural technique with providing better post-operative analgesia. Material and Methods: 50 paediatric patients up to 12 years of ASA grade I and II posted for lower abdominal and lower limb surgery were randomly divided in to two groups. Group C (n=25) received caudal epidural anaesthesia using Lignocaine with adrenaline, Bupivacaine and Tramadol. Group G (n=25) received general anesthesia with Thiopentone, Succinylscoline as induction agent and O 2, N 2 O, Isoflurane and incremental doses of Atracurium as maintenance. They were extubated in a usual manner after surgery. Observation and Results: Consent rate was higher for caudal block. Onset of caudal block achieved in average 6.6 minutes with higher success rate. Surgeons acceptance was good in group C. Cost was very less in group C as well. Time for pre-operative preparation was less in Group G. Hemodynamic variation and duration of rescue analgesia was significant in group G. Rate of post-operative complication was higher in group G. Conclusion: Caudal epidural is quite inexpensive with excellent anaesthesia and satisfactory post operative analgesia with lesser complication rate.

[1]  N. Badawi,et al.  Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy. , 2015, The Cochrane database of systematic reviews.

[2]  R. Fumagalli,et al.  Randomized controlled trial of duration of analgesia following intravenous or rectal acetaminophen after adenotonsillectomy in children. , 2008, British journal of anaesthesia.

[3]  J. Alhashemi,et al.  Effect of intrathecal tramadol administration on postoperative pain after transurethral resection of prostate. , 2003, British journal of anaesthesia.

[4]  M. Demircan,et al.  Regional anesthesia is a good alternative to general anesthesia in pediatric surgery: Experience in 1,554 children. , 2002, Journal of pediatric surgery.

[5]  D. Maloney,et al.  Caudal analgesia in children , 1999, Anaesthesia.

[6]  B. Dalens Regional Anesthesia in Children , 1989, Anesthesia and analgesia.

[7]  R. Eyres,et al.  Plasma Bupivacaine Concentrations in Children during Caudal Epidural Analgesia , 1983, Anaesthesia and intensive care.

[8]  R. McGown Caudal analgesia in children , 1982, Anaesthesia.

[9]  L. Flohé,et al.  Effect of the opioid analgesic tramadol on inactivation of norepinephrine and serotonin. , 1982, Biochemical pharmacology.

[10]  S. Z. Hassan Caudal anesthesia in infants. , 1977 .

[11]  B. De Jose Maria [Regional anesthesia in children]. , 2010, Revista espanola de anestesiologia y reanimacion.

[12]  R. Lakshmy,et al.  Caudal epidural sufentanil and bupivacaine decreases stress response in paediatric cardiac surgery. , 2009, Annals of cardiac anaesthesia.

[13]  جمال الهاشمي Effect of intrathecal tramadol administration on postoperative pain after transurethral resection of prostate. , 2003 .