combination of tramal with bupivacine versus bupivacaine alone in wound infiltration and ilioinguinal blocks in herniotomy

To evaluate the analgesic efficacy and tolerability of tramadol with bupivacaine, in comparison with bupivacaine alone. This was a double-blind randomized study on 300 Paediatric patients undergoing inguinal hernia repair under general aneasethsia with local infiltration anesthesia and ilioinguinal blockade at Queen Rania Paediatric Hospital, Jordan. Post operative pain at 1,2,3,6, 12 and 24 hours and analgesic requirements [paracetamol and Ibuprofen] were assessed. Two hundred ninety patients were admitted for twenty four hours for evaluation, four patients were discharged because parents refuse admission. The median intra-operative VAS score was 10 [IR 15] in group I, receiving the combination of 2 drugs vs. 12 [IR 16] in group II, receiving bupivacaine alone, [P = 0.02]. There was no difference in pain scores or analgesic requirements at 12 hour post-operatively]. Distribution of intra-operative VAS scores showed a greater number [P<0.05] of patients having a VAS score > 30 post-operatively in patients receiving the combination of both drugs vs. bupivacaine alone. The use of combination of Tramal and Bupivacaine infiltration with ilioinguinal blocks is more effective than the bupivacaine group alone and can produce rapid onset of block and also stays for longer duration. We recommend this technique for groin hernia repair to reduce post-operative pain

Plain lignocaine 1% and bupivacaine 0.5% infiltration as comparison study in pediatric tonsillectomy

One hundred sixty children were planed for elective tonsillectomy under general anaesthesia. They were divided into two groups. First group [group A: seventy five children] received injection of local analgesic lignocaine hydrochloride 1% in a dose of 1.5 mg/kg in the peritonsillar area. The second group [group B: eighty five children] was given O-5% Marcaine [Bupivacaine], in a dose of O.75 mg/kg around each tonsil after induction of anaesthesia. All patients were assessed on awakening, and after 30 minutes, one hour, two hours, four hours, six hours, 12 hours, using the pain scores 1-5 pain scores on awakening, and after 30 minutes, one hour, two hours, four hours, six hours were significantly lower in the second group, but in the first group pain scores were lower until two hours post operatively. Bupivacaine 0.5% as local infiltration in the peritonciller area has more prolonged effect and more potent as analgesic in children having tonsillectomy in comparison with lignocaine 1%