Mohsin Riaz Askri, Shumyala Maqbool, Muhammad Afzal Mirza, Muhammad Rauf.
Postoperative Analgesia in Childres; Comparison of Mean Duration of Pain Relief Using Caudal Bupivacaine with and Without Neostigmine for Postoperative Analgesia in Children Undergoing Infra-Umbilical Surgery.
Professional Med J Jan ;25(7):1069-72.

Objectives: To compare the mean duration of pain relief using caudal bupivacaine with and without neostigmine for postoperative analgesia in children undergoing infra-umbilical surgery. Study design: Randomized Controlled trial. Settings: Department of Anaesthsia Children Hospital/Institute of child health Faisalabad& Independent university hospital Faisalabad. Duration of Study: Six months from July 2017 to December 2017. Methods: 60 patients (30 in each group) were included in this study. Group-A given 1ml/kg of 0.25% caudal bupivacaine and Group-B given 1ml/kg of 0.25% caudal bupivacaine and 2µg/kg neostigmine. Results: Mean age was 4.20±1.09 and 4.13±1.07 years in group-A and B, respectively. Sex distribution shows, 22 patients (73.3%) in group-A and 9 (30.0%) in group-B were male while 8 patients (26.7%) of group-A and 11 patients (36.7%) of group-B were female. Mean duration of relief of pain (hours) in group-A was 6.70±2.12 hours and in group-B was 11.97±3.80 hours. Difference between group-A and group-B was considered statistically significant (P<0.001). Conclusion: Neostigmine with bupivacaine caudally in paediatric patients increases the duration of analgesia. However, neostigmine may be used for prolongation of caudal analgesia.

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