Bupivacaína-buprenorfina vs. bupivacaína por vía caudal para analgesia postoperatoria en el paciente pediátrico en cirugía ortopédica

Background: postoperative pain in children is a special entity and that the influence various factors, therefore it is an unexpected experience for the child and more difficult to treat. Objective: to evaluate and compare the length and quality of post-operative caudal analgesia and hemodynamic stability and adverse effects between bupivacaine-buprenorphine against bupivacaine. Material and methods: a controlled clinical trial, prospective, longitudinal, comparative study included 40 patients 1-7 years for orthopedic surgery under caudal block in the HTO No 21, of Monterrey, Nuevo Leon, from May 2009 to January 2010. Are assigned at random to two groups: group A 0.25% bupivacaine 1.4 ml/kg, and group B bupivacaine mL/kg 0.25% 1.4 mg/kg of buprenorphine. The intensity of postoperative pain was measured using a VAS, NIPS AND CRIES at 2, 4, 6, 12 and 24 hours later. Statistical analysis: Student t-test, Mann-Whitney and Chi square test. Results: the time of first analgesic administration after surgery was shorter in group A (5.33 vs. 8.46 hours), with a difference in favor of group B (p < 0.05). Rescue doses were lower for the experimental group (22 vs. 17, p < 0.05). Side effects were minimal the most significant urinary retention, nausea and vomiting. Conclusion: the combination of buprenorphine-bupivacaine in children produces a longer postoperative pain-free, with reduced doses of rescue analgesics within 24 hours.