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Material and Methods: After approval by the Ethics Committee and informed consent from parents was undertaken, 24 ASA status I-II, aged between 1-7, undergoing herniotomy, sircumcision, hipospadias or orsiopexy. Anaesthesia was induced via face mask, with inhaled sevoflurane 8% concentration and 50% N2O in oxygen. Patients were randomly divided into two group to receive either caudal R alone (0.2%, 1 ml kg−1) in group R (n = 12) or R (0.2%, 1 ml kg−1) plus tramadol (1.5 mg kg−1) in group T (n = 12). Heart rate, mean arterial pressure and pulse oximetry were recorded before induction, after induction and during surgery. Pain score and sedation score values were recorded at hours 2, 4, 6 and 12. Pain was evaluated using the modified TPPPS score; sedation was evaluated by using the four-point sedation score. Statistical analysis were performed Independent Samples t test, Mann Whitney U test and Chi-square test. p < 0.05 was considered at statistically significant.
Results: Pain scores were every similar at 2 and 4 hours but lower in group T than group R at 6 and 12 hours (Table 1). Sedation scores were not significantly different at the same time (p > 0.05). The mean duration of caudal analgesia (time to first analgesic requirement) was 10.72 ± 4.77 hour (h) in group T compared with 6.54 ± 2.01 hour in group R (p = 0.037). The incidence of vomiting was higher in group T (n = 5; % 41.7) than group R (n = 2; % 16.7) (p = 0.37).
Conclusion: We concluded that a single caudal injection of tramadol when added to ropivacaine provide an advantage over ropivacaine alone for postoperative pain relief in children undergoing lower abdominal surgery.
