RESUMEN
Caudal analgesia with bupivacaine is used commonly for pain relief in children and extradural administration of tramadol seems to be a safe method of analgesia. The aim of the study was to compare the analgesic efficacy of caudal bupivacaine and bupivacaine and tramadol mixture for postoperative analgesia and to observe for the side effects. Department of Anesthesia and Intensive Care Unit, Bahawal Victoria Hospital, Bahawalpur. 01-12-2010 to 30-11-2011. Eighty children, aged between 2 to 12 years of age undergoing infra umbilical surgeries were selected for this randomized, controlled trial. They were randomly divided into two groups A and B. Group A [n = 40] received 0.5 ml/kg of 0.25% bupivacaine and Group B [n = 40] received 0.5 ml/kg of 0.25% bupivacaine with 1 mg/kg of tramadol as a single shot caudal block. In the postoperative period, duration of analgesia, pain score, nausea, vomiting and side effects were noted and analyzed. Patients in both groups were comparable for age and weight. It was observed that the mean duration of analgesia in group A patients was 6.23+0.68 hours while in group B, it was 9.33+0.72 hours [p<0.05]. Nausea and vomiting was present in 20% [n=8] patients in group A, while in group B, 27.5% [n=11] had nausea and vomiting in the post operative period [p<0.05]. None of the patients in both the groups had complications like motor weakness, urinary retention in the postoperative period. The addition of tramadol to bupivacaine in the caudal analgesic technique provides longer analgesia and lesser need for rescue analgesia in the postoperative period compared to bupivacaine alone
RESUMEN
To compare the primary repair with colostomy in colonic injuries at tertiary care hospital in terms of morbidity and hospital stay. Quasi experimental study. This study was conducted in the Department of Surgery, Unit II BVH Bahawalpur from 27-01-2010 to 31-8-2010. A total of sixty patients fulfilling the inclusion criteria were selected for this study. Patients were randomly allocated in two groups. Group A [Primary Repair] and Group B [Colostomy], 30 patients in each group. Follow up in group A patients was done twice after 2 weeks and after one month. The follow up in group B was done for multiple times. Initially the visit was advised after every two weeks until the patient was called back for colostomy closure. The mean age in group A was 28.9 +/- 8.1 years and in group B was 30.1 +/- 14.0 years. The mean hospital stay in group A was 8.9 +/- 3.65 days and in group B was 11.0 +/- 4.7 days. At two weeks follow up, in group A, there was one [3.3%] patient of abscess, one [3.3%] of suture repair leak, one [3.3%] patient of sepsis and 2 [6.7%] patients of wound infection. In group B, there were 2 [6.7%] patients of abscess, one [3.3%] patient of suture repair leak, 3 [10%] patients of sepsis and 4 [13.3%] patients of wound infection. This is concluded from our study that primary repair was safe and effective treatment modality in the management of colonic injuries as compared to colostomy