BEFORE YOU READ THE ABSTRACT OR CHAPTER ONE OF THE PROJECT TOPIC BELOW, PLEASE READ THE INFORMATION BELOW.THANK YOU!
INFORMATION:
YOU CAN GET THE COMPLETE PROJECT OF THE TOPIC BELOW. THE FULL PROJECT COSTS N5,000 ONLY. THE FULL INFORMATION ON HOW TO PAY AND GET THE COMPLETE PROJECT IS AT THE BOTTOM OF THIS PAGE. OR YOU CAN CALL: 08068231953, 08168759420
WHATSAPP US ON 08137701720
COMPARISON OF THE COMBINATION OF CAUDALLY ADMINISTERED BUPIVACAINE AND RECTALLY ADMINISTERED DICLOFENAC WITH CAUDALLY ADMINISTERED BUPIVACAINE ALONE FOR POSTOPERATIVE HERNIOTOMY PAIN MANAGEMENT IN CHILDREN
ABSTRACT
The use of caudally administered bupivacaine is a standard practice of providing
perioperative analgesia for children undergoing infraumbilical procedures. However, the
duration of action of caudal bupivacaine is relatively short. Methods to prolong the duration of
action of bupivacaine include co-administration of caudal bupivacaine and preservative-free
drugs like opioids, ketamine and clonidine. But the side-effects of such mixtures make the use
of alternative methods imperative.
The use of rectal diclofenac as adjunct to caudal bupivacaine might provide superior quality
of postoperative analgesia compared to caudal bupivacaine alone, with relatively less side
effects. It was therefore hypothesised that the combination of caudally administered
bupivacaine and rectal diclofenac would provide a better quality of postoperative analgesia
than caudal bupivacaine alone. The aim of this study therefore, was to compare the quality of
postoperative analgesia achieved with the combination of caudally administered bupivacaine
and rectally administered diclofenac to caudally administered bupivacaine alone in children
undergoing herniotomy.
Following the institution’s Ethics Committee approval, 62 patients aged between 1 and
6 years scheduled for herniotomy were recruited and randomised to two groups (31 in each
group). Baseline haemodynamic parameters were recorded and anaesthesia was induced with
halothane in 100% oxygen using facemask. Plain bupivacaine 1ml/kg of 0.25% was caudally
administered in group I patients. Group II patients received a combination of caudal
bupivacaine 1ml/kg of 0.25% and rectal diclofenac 1mg/kg.
Anaesthesia was maintained with halothane 0.5 to 1.5% in 100% oxygen with patients
breathing spontaneously. Intraoperative haemodynamic parameters were monitored.
Postoperative pain was assessed for 24 hours using the Objective Pain Scale. The primary
outcome measure was the proportion of pain-free patients at pain assessment intervals. Data
were analysed using SPSS 11.0. Continuous data were compared using t-test while categorical
data were compared using Fisher’s exact test. P-values < 0.05 were considered significant.
There was no difference in the proportion of pain-free patients in both groups in the first 4
hours observation period. However, significant difference in the proportion of patients who
were pain-free was first observed at 6 hours postoperatively with eleven patients (35.48%) in
group I and 29 (93.5%) in group II having no pain (P <0.001). At 12 hours, 15 patients (48.38%)
were pain free in group I as against 25 (80.64%) in group II (P=0.02). No difference was
observed between both groups at 24 hours (P=0.24).
Time to first analgesic requirement was 6.83±2.67 hours in group I and 14.03 ± 2.51 hours
in group II with a marked significant difference (P <0.001). The mean paracetamol
consumption in 24 hours was significantly higher in group I (532.90±119.05mg) compared to
311.60 ±71.28mg in group II (P <0.001). The frequency of paracetamol administration was
more in group I (3.32 ±0.48) as against 2.06±0.25 in group II (P <0.001). However, changes in
the intraoperative haemodynamic parameters were comparable in both groups. The incidence
of complications were also similar in both groups (p=1.00).
This study showed that the use of the combination of caudally administered bupivacaine
and rectally administered diclofenac is superior to caudally administered bupivacaine alone for
postoperative analgesia in patients undergoing herniotomy
HOW TO RECEIVE PROJECT MATERIAL(S)
After paying the appropriate amount (#5,000) into our bank Account below, send the following information to
08068231953 or 08168759420
(1) Your project topics
(2) Email Address
(3) Payment Name
(4) Teller Number
We will send your material(s) after we receive bank alert
BANK ACCOUNTS
Account Name: AMUTAH DANIEL CHUKWUDI
Account Number: 0046579864
Bank: GTBank.
OR
Account Name: AMUTAH DANIEL CHUKWUDI
Account Number: 3139283609
Bank: FIRST BANK
FOR MORE INFORMATION, CALL:
08068231953 or 08168759420