Çocuklarda kaudal prilokain, bupivakain veya ropivakainin postoperatif analjezik etkilerinin karşilaştirilmasi

Objective: The aim of the study was to compare the effects of prilocaine, bupivacaine and ropivacaine for postoperative pain management in children. Method: Sixty ASA I-II children between 1 and 7 years of age and scheduled for urologic surgery with general anaesthesia were recruited. The patients were randomly allocated into three groups. Group I received caudal prilocaine 1% 0.5 mL kg^-1 after the operation, Group II received 0.25% 1 mL kg^-1 bupivacaine and Group III received 0.25% 1 mL kg^-1 after induction of anesthesia. During anaesthesia, hemodynamic parameters and fentanyl requirements were recorded. Haemodynamic parameters, sedation and pain scores were recorded at 15 and 30 minutes, 1, 2, 4 and 6 hours following recovery from anaesthesia. Pain was evaluated by CHEOPS and sedation with a five point sedation test. Results: Demographic data were similar in all groups. No statistically significant differences between the groups were observed in intraoperative haemodynamic parameters. The first analgesic requirement time was 247.5±159.0 minutes in Group I, 315.0±117.8 minutes in Group II and 340.2±93.9 minutes in Group III. The intraoperative fentanyl requirement was higher in Group I than in the other two groups (p<0.05). Sedation scores and CHEOPS were similiar in all groups. No motor block was seen in either group on awakening. There were no differences in the insidence of emesis, vomiting and urinary retention among the groups. Conclusion: All three anesthetic agents may be used effectively in caudal anesthesia in children but time to first analgesic requirement was found to be shorter for prilocaine.