Comparison of Local Infiltration of Bupivacaine and Tramadol in post-operative pain management in children after inguinal herniotomy

Adequate pain control is essential in immediate post-operative period. Different methods are being used to provide pain management but none of these is completely effective. Regional blocks are becoming more popular then systemic opioids in all age groups due to efficacy and safety of agents used. The objective of this study was to determine the effectiveness of tramadol and bupivacaine for post-operative analgesia after inguinal herniotomy in children. Material & This was a randomized controlled trial conducted at pediatric surgery department, services hospital Lahore over 2years. 284 cases randomly divided in two groups B (Bupivacaine) & T (Tramadol). Bupivacaine (dose of 3 mg/kg) in group B or Tramadol (2mg/kg) in group T was infiltrated in the wound. Postoperatively pain score was measured using Wong-Baker Faces pain scale at 0,1,2,4 and 8 hours. Side effects were noted in both groups. Age and gender distribution in both the groups were comparable. Pain score noted in both Groups was equal in both groups at 0- hours. however at 1-hour, 2-hour and 4-hour, pain score was slightly more in Group-B. But at 8-hours mean pain score was markedly raised in Group-B as compared to Group-T (3.32 ± 1.42 vs 2.45 ± 1.35). Only complication noted in patients was vomiting which was higher in Group T. Locally infiltrated Tramadol is a better choice than bupivacaine as a local anesthetic for pain management in children after inguinal herniotomy. Further research is needed to elucidate any benefits it may have in other surgeries.