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Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 2 No. 2 (2011)

Assesment of The Effect of Multimodal Preemptive Analgesia in Children

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2011
CONTENTSVolume 02Number 2July 2011
Editorial
Laparoscopy in Children, A Brief Outline and Bangladesh Perspective
Md. Jafrul Hannan
42
Original Articles
Outcome of Vesiciureteric Reflux After Primary Fulguration of Posterior Urethral Valves
M. M. Masud Pervez, Kaniz Hasina, Md. Ashraf Ul Huq, Md. Nooruzzaman, Abdul Hanif
46
Post A-H Pyeloplasty Analysis of Renal Function in Unilateral Hydronephrosis Due to Congenital Pelviureteric Junction Obstruction
Nandan Kumar Majumder, Md. Ruhul Amin, Rajib Khastgir, Mizanur Rahman, Md. Abu Bakar Akan
53
Assesment of The Effect of Multimodal Preemptive Analgesia in Children
Md. Nooruzzaman, MM Masud Pervez, Md. Abu Bakar Akan, M Anisuzzaman, Md. Nazrul Islam, AM Shahinoor
56
Early Post-operative Outcome of Primary Repair of Bladder Exstrophy With or Without Osteotomy
S. M. Borhan Uddin, Md. Abu Bakar Akan, Rajib Khastgir, Md. Ruhul Amin
63
Evaluation of Congenital Upper Urinary Tract Anomalies in Hypospadias
Md. Abdullah Al Farooq, Shafiqul Hoque
68
Decreased Morbidity and Mortality from Intestinal Ascariasis: Experience of a Single Center
Md. Akbar Hossain Bhuyian, Md. Abdullah Al Farooq, Md. Minhajuddin Sajid, MA Mushfiqur Rahman, Md. Momtazul Hoque, Khurshid Alam Sarwar, Tanvir Kabir Chowdhury, Mahfuzul Kabir, Tahmina Banu
73
Case Reports
Desmoplastic Small Round Cell Tumour (DSRCT) - A Case Report and Review of Literature
AKM Amirul Morshed, Farhana Afroz, Chowdhury Md. Fuad Galib, Shahnoor Islam, Kaniz Hasina, Ashish Kumar Ghosh
79
Spontaneous Common Bile Duct Perforation on The Background of Pancreatic Lithiasis: A Case Report and The Review of The Literatures
Md. Abdullah Al Farooq, M A Mushfiqur Rahman, Mahfuzul Kabir, Md. Akbar Husain Bhuiyan, Md. Minhajuddin Sajid, Rupam Talukder, Tanvir Kabir Chowdhury, Tahmina Banu
83
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ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Md. NooruzzamanMedical Officer (OSD), DGHS, Dhaka
  • MM Masud PervezDepartment of Urology, BIRDEM Hospital, Dhaka
  • Md. Abu Bakar AkanMedical Officer, Upzilla Health Complex, Swarupkathi, Pirojpur
  • M AnisuzzamanDepartment of Surgery, Holy Family Red Crescent Hospital, Dhaka
  • Md. Nazrul IslamDepartment of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka
  • AM ShahinoorDepartment of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka

Keywords

Multimodal Preemptive Analgesia Post-operative pain

Abstract

Background: Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain. Pain is inevitable after any surgery. Surgery offers the most promising setting for preemptive analgesia because the timing of noxious stimuli is known. Materials & Methods: This prospective double blind study included 60 children (30 in each group), undergoing major surgery under general anesthesia. Each patient in the study group (Group II) received pre-emptive analgesia (Local anesthesia, per-rectal diclofenac just prior to surgery, per-rectal paracetamol 2 hours prior to surgery) and regular pattern of postoperative pain intervention with per rectal diclofenac and per rectal or oral paracetamol in different phases of postoperative pain management up to 48 hours. On the other hand, each patient of control group (Group I) received pre-emptive analgesia (Local anesthesia & per-rectal diclofenac) regular pattern of postoperative pain intervention with per-rectal diclofenac in different phases of postoperative pain up to 48 hours. The degree of postoperative pain was assessed by universal pain assessment tools (VAS) at defined intervals. Results: Most children in the study group (Group II) has significantly better postoperative pain control with only mild pain at 4th postoperative hours. It is obvious that less pain in Group-II due to synergistic effect of paracetamol and diclofenac. In the control group (Group I) there was persistence of mild pain throughout the observation period i.e. up to 48 postoperative hours. The breakthrough pain occurred more in latter group, two patients needed rescue analgesia. Whereas no patient experienced breakthrough pain requiring rescue analgesia in study group (Group II). Conclusion: Therefore this study concludes that administrations of multimodal pre-emptive analgesia control pain more effectively in children in view of both the degree of pain control and sustainability of pain free state.

Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (2): 56–62

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