Abstract

Objective: This study was designed to evaluate the analgesic efficacy of caudal midazolam-bupivacaine combination in providing post-operative pain relief in children undergoing genitourinary surgery and to study the occurrence of adverse effects. Subjects and methods: Thirty children, aged 2 to 8 years, scheduled for genitourinary surgery were allocated randomly to receive either 0.25% bupivacaine 0.5 ml/kg (group B; n = 15) or 0.25% bupivacaine 0.5 ml/kg with 50 mg/kg midazolam (group BM; n = 15) by the caudal route immediately after induction of general anesthesia. Heart rate, arterial blood pressure and oxygen saturation were monitored throughout the study period. Post-operative pain was assessed at regular intervals for 12 hours using an objective pain score. Analgesia was supplemented whenever the pain score was ³ 4. Duration of analgesia, as well as the requirement of additional analgesics, were noted. Results: Lowest pain scores were observed with the addition of midazolam to caudal bupivacaine (p < 0.01). Duration of analgesia was longer in group BM (11 ± 0.5 h) as compared to group B (7.4 ± 2.1 hours) (p < 0.05). Fewer children (26.6%) required additional analgesia in the combination group whereas in group B, 60% of the children received analgesic supplements within 6 hours after surgery (p < 0.05). There were no significant changes in heart rate, blood pressure and oxygen saturation in both groups. We observed no untoward event in either of the groups. Conclusion: Caudal administration of bupivacaine-midazolam mixture prolongs post-operative analgesia compared to bupivacaine alone without causing any adverse effects.

Author Details

Authors

• R. Mahajan
• Y.K. Batra
• V.K. Grover
• J. Kajal

Departments

• Department of Anesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Address

Dr. Y.K. Batra; Department of Anesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Citation