Post operative analgesia in infants

ABSTRACT

To compare the effects of local wound infiltration of bupivacaine with intramuscular nalbuphine in infants as post operative analgesia. Comparative study. Place and Duration of study Department of Paediatric Surgery, National Institute of Child Health, Karachi, during years 2002-2003. A total of 60 patients included in this study. They were divided into 3 groups of 20 patients each. All were selected for elective inguinal herniotomy and randomly distributed in 3 groups. Group I was control group in which no analgesia was given and patients were observed for pain. Group II consisted of patients who were given nalbuphine post operatively and in group III bupivacaine was infiltrated into the wound margins just before wound closure. Observational pain assessment was performed according to Infants Pain Scale of Barrier et al. Results of the mean of 3 groups were compared with each other to assess severity of pain. Group I [control] showed signs of moderate to severe pain. Out of 20 patients, 16 had moderate and 4 had severe pain. In Group II [nalbuphine] 18 patients demonstrated mild pain while only 2 patients remained symptom free and in group III [bupivacaine] out of 20 patients 9 developed mild pain while 11 patients had no pain at all. Thus bupivacaine proved significantly better than nalbuphine [p<0.01] as post operative analgesia in infants. Bupivacaine as compared to nalbuphine is more effective as a post operative analgesia. This makes the drug most suitable for routine use, especially in day care surgery