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Post-operative analgesic effect of caudal neostigmine added to bupivacaine as compared with caudal bupivacaine alone for pediatric elective infra umbilical surgery at Tikur Anbesa specialized hospital.

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dc.contributor.advisor Admasu, Wosenyeleh (BSc, MSc in ACA, Lecturer, Ass prof)
dc.contributor.advisor Awoke, Senait(BSc, MSc in ACA, Lecturer)
dc.contributor.author Guadie, Yitayal
dc.date.accessioned 2021-01-13T08:45:16Z
dc.date.available 2021-01-13T08:45:16Z
dc.date.issued 2020-06
dc.identifier.uri http://etd.aau.edu.et/handle/123456789/24642
dc.description.abstract Background: Caudal epidural block is one of the most commonly used, popular, safe and easy regional anesthetic techniques to be performed in children undergoing infra-umbilical surgeries. The main disadvantage of single-shot caudal anesthesia is the short duration of action. Neostigmine is one of adjuvant with local anesthetic agents to improve the efficiency and quality to prolong the duration of analgesia after surgery. Objective: To assess the effect of adding neostigmine to bupivacaine on post-operative analgesia in pediatric patient during infra umbilical surgery at Tikur Anbesa specialized hospital from November1, 2019 to January 30, 2020 G.C. Methodology: Hospital based Prospective cohort study was conducted among 68 children’s, whose aged is between 1-12 years, American Association of Anesthesiologists I & II undergoing elective infra umbilical surgery received caudal bupivacaine alone or bupivacaine with neostigmine. A systemic random sampling technique was used to select study participants. Postoperative severity of pain, time to request and total analgesic consumption was evaluated up to 24 hours after the operation. Based on the normality assumption, the analysis was done by independent sample t- test, a chi-square test and Mann–Whitney U-test. A p-value <0.05 was considered as statistically significant. Result: In this study the median duration of postoperative analgesia in neostigmine group was 644 min while it was 322.5 min in bupivacaine alone group with statistically significant difference. With p-value <0.0001. Median postoperative pain severity was being statistically significant difference at 4 th , 8 th , 12 th and 24 th hour with p-value of <0.05 but it was statistically insignificant at arrival, 1 st and 2 nd hour. Median post-operative analgesic consumption in mg within 24 h neostigmine group was 250 and bupivacaine alone group was 750 statistically significant with p-value of <0.0001. Conclusion and Recommendation: Caudal neostigmine with bupivacaine provides effective post-operative analgesia in pediatrics undergoing infra-umbilical surgeries. Based on this we recommend that neostigmine in the dose of 2µg/kg added to caudal bupivacaine is safe and with less or no side effect statistically significant. en_US
dc.language.iso en_US en_US
dc.publisher Addis Abeba University en_US
dc.subject Caudal block, bupivacaine, neostigmine, analgesic effect, infra umbilical surgery. en_US
dc.title Post-operative analgesic effect of caudal neostigmine added to bupivacaine as compared with caudal bupivacaine alone for pediatric elective infra umbilical surgery at Tikur Anbesa specialized hospital. en_US
dc.type Thesis en_US


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