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Indian Journal of Anesthesia and Analgesia

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Is General Anaesthesia with Paediatric Epidural Anaesthesia Superior to General Anaesthesia Alone in Improving Postoperative Outcome?: A Clinical Study

Uma B.R., Professor, Department of Anaesthesiology, JJM Medical College, Davangere, Karnataka 577004, India. , Uma B.R.1 , Priyadarshini M. Bentur2

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Indian Journal of Anesthesia and Analgesia 4(4):p 1222-1228, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.49

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Abstract

Background: Paediatric epidural anaesthesia and analgesia (PEA) is being accepted as a standard method of advanced pain management as epidural catheter offers the advantage of excellent long term post-operative analgesia. Aims: This prospective randomised study compares General Anaesthesia (GA) and General Anaesthesia with Paediatric Epidural Anaesthesia (GA+PEA) with regard to (i) Quality of post-operative analgesia (ii) Requirement of rescue analgesics (iii) Parental satisfaction and (iv) Complications if any. Material & Methods: 80 children of ASA status I & II (2 to 12 yrs), scheduled for elective surgeries were randomly assigned to GA or GA+PEA groups. Both the groups received routine GA. In GA+PEA group, an epidural catheter was inserted. Post-operatively, in the GA group, analgesia was facilitated with Paracetamol suppository 15mg/kg, in GA+PEA group with epidural infusion of 0.125% Bupivacaine. Pain assessment was done with CHIPPS (2 to 6 yrs) and VAS (7 to 12 yrs) scale. Rescue analgesia was supplemented if pain scale was more than 3. Parental satisfaction was assessed. Statistical Analysis: Chi-square test, student-t test and ANOVA test were used to analyse categorical, demographic and rescue analgesic requirements respectively. A p value<0.05 was considered significant. Results: The pain scores and requirement of rescue analgesics were significantly lower with p<0.001 and p=0.018 respectively in GA+PEA as compared to GA alone. The overall parental satisfaction was significantly greater in GA+PEA with p<0.001. Conclusion: GA+PEA offers advantages of improved post-operative analgesia, decreased requirement of rescue analgesics and greater parental satisfaction.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.49

Keywords

Paediatric Epidural; Postoperative Analgesia; Rescue Analgesic; Parental Satisfaction. 

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