Recovery Status in Children after General Anaesthesia: Role of Pre-emptive Local Anaesthetic Infiltration

Abstract

This prospective clinical study was carried out in the dept. of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU. Dhaka during the period of January 04 to September 04. The study was done to emphasize the importance of giving analgesics preemptively instead of waiting for the child to complain or express their pain and to improve post operative recovery status and associated response by reducing the immediate post operative pain with simple local anaesthetic infiltration. The children scheduled for elective herniotomy operation through a hernial incision under general anaesthesia were recruited in this study. Immediate recovery status in children was compared with preemptive (group-1 and without preemptive (group-II) local infiltration of 0.25% bupivacaine in herniotomy operation. No. of patients was 20 in each group. Pulse, systolic, diastolic and mean pressure, oxygen saturation, pain (scored by TPPPS), anaesthetic recovery (scored by steward recovery system) and mental status if the children were observed postoperatively at different time interval up to one hour.

Pulse, systolic, diastolic, mean pressure were stable in group-1 then group-II. Oxygen saturation in both the groups were in clinically acceptable range but in group-11 5 mins after extubation fall more than that of group- l and statistically significant. Pain score (TPPPS) in group-1 was lower all the time period but in group-II the score was high, all the children required rescue pethidine within 10 mins after extubation, mean dose reqd, in group-II was 23.6+3.6mg. Steward recovery score in both group was not significant at early period but after 10 mins. P value become significant The mental state of group-I was calm & quite only 3 were excited, on the other hand in group-11 all children were excited & irritable and required rescue pethidine. So preemptive local infiltration of 0.25 bupivacaine improved the recovery status in children by reducing the immediate postoperative pain and there by decrease in postoperative morbidity.

Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.38-44