The optimum initial pediatric epidural bolus: a comparison of four local anesthetic solutions

Epidural ropivacaine versus ropivacaine plus tramadol in postoperative analgesia in children undergoing major abdominal surgery: a comparison

PURPOSE

In this study, we aimed to compare the effects of ropivacaine alone and ropivacaine plus tramadol administered epidurally for postoperative analgesia in children.

METHODS

Following Ethics Committee approval and informed parent consent, 44 children aged between 2 and 12 years, with ASA physical status I or II, who were undergoing major abdominal surgery were included in the study. Following tracheal intubation, patients were placed into lateral decubitus position and an epidural catheter (22-24 G) was inserted by using a Tuohy needle. Patients were randomly divided into two groups to receive either ropivacaine alone (0.2%), 0.7 ml/kg, in group I, or ropivacaine (0.2%) plus tramadol (2 mg/kg), with total volume 0.7 ml/kg, in group II, epidurally in both groups. Hemodynamic variables, pain and sedation scores, duration of analgesia, and side effects were recorded postoperatively.

RESULTS

The duration of analgesia was significantly longer in group RT than in group R (298.6 ± 28 and 867.9 ± 106.8 min in group I and II, respectively) (P < 0.05). CHEOPS scores were significantly lower in group RT at 30 min, 45 min, and 3 h postoperatively than in group R (P < 0.05). However, sedation scores were similar between the two groups. Twenty-two patients (100%) in group R and 13 patients (59%) in group RT needed supplemental analgesia postoperatively. There were no significant differences in side effects between the groups.

CONCLUSION

In children undergoing major abdominal surgery, epidural tramadol, added to epidural ropivacaine, provided lower pain scores, longer duration of analgesia, and lower postoperative analgesic requirement.