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CURE has a comprehensive approach to providing surgical care for children with disabilities. We support their families and strengthen the capacity of local church and healthcare systems in the countries we serve.

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Motivated by our Christian identity, CURE operates a global network of children’s hospitals that provides life-changing surgical care to children living with disabilities.

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CURE International is a global nonprofit network of children’s hospitals providing surgical care in a compassionate, gospel-centered environment. Services are provided at no cost to families because of the generosity of donors and partners like you.

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Anesthesia

Effectiveness of caudal epidural block using bupivacaine with neostgmine for pediatric lower extremity orthopedic surgery in CURE Ethiopia Children’s Hospital

Abstract:

Background: This study was conducted to assess analgesia and side effects of neostgmine administered with
caudal bupivacaine for pediatric lower extremity orthopedic surgeries in routine clinical practice.

Methods: In this blinded effectiveness trial, we studied 86 children aged 1-12 years undergoing lower extremity orthopedic surgeries. After induction of general anesthesia, 43 children in Group-B received 1 ml/kg of 0.25% bupivacaine and the other 43 in Group-BN received 1 ml/kg of 0.25% bupivacaine with 2.5 mic/kg neostgmine caudally. Demographic data, hemodynamic data before and after caudal, ASA status, duration of general anesthesia, duration of surgery, episode of post-operative nausea and vomiting (PONV), frequency of rescue analgesics per 24 hour, pain score and sedation score were recorded. Analgesic duration was defined as time from caudal injection to first rescue analgesic administration. Mann-Whitney test to compare median values and chi-square test for nominal data were used. A value “P<0.05” was considered as statistically significant.

Result: The median analgesic duration in Group-B was 5.8 ± 2.3 hr and 8.7 ± 5.3 hrs in Group-BN (p=0.003). Number of patients who required rescue analgesic drug doses within 24 hr twice, four times and more than four times were significantly different among the groups (p<0.05). There was no difference among the groups regarding pain and sedation scores. The PONV incidence was observed in Group-B (4.6%) and Group-BN (13.9%) which is not statistically significant (p>0.05) across the groups.

Conclusion: In routine clinical practice, addition of neostgmine to caudally administered bupivacaine prolongs analgesic duration without significant difference in PONV. It also decreases rescue analgesic consumption within 24 hours.

Publication: Journal of Anesthesia and Clinical Research
Publication Year: 2014
Authors: Ataro, G. , Bernard, M.
Tags
Analgesia
Bupivacaine
Caudal epidural block
Neostigmine