PAIN RELIEF IN PEDIATRIC PATIENTS UNDERGOING THORACOTOMY FOR CONGENITAL HEART DISEASES WITH CAUDAL ANAESTHESIA

Objectives: To assess the frequency of pain relief, using FLACC scores, in pediatric patients undergoing thoracotomy for congenital heart diseases with caudal anesthesia. Study design: Descriptive study Setting: Department of Anesthesiology, National institute of Cardiovascular Diseases, Karachi Study duration: 26th August 2019 to 25th February 2020. Materials & Methods: A total of 74 patients undergoing Thoracotomy for Congenital Heart Diseases and of age 6 months-6 years were included. Patients with bleeding disorders and skin lesion at site of needle insertion were excluded. Anesthesia fitness was obtained and a local anesthetic injection (Bupivicaine; dosage 1.5ml/kg) was injected in to the caudal canal. Thoracotomy and surgery was performed by pediatric surgeon with minimum experience of five years. Patients were kept under observation and Face, Legs, Activity, Cry, Consolability (FLACC) score was evaluated and noted after six hours of the surgery by principal investigator. We administered our rescue analgesia in form of Nalbuphine if pain intensity found to be moderate to severe on FLACC scale. Results: Age range in this study was from 6 months to 6 years with mean age of 3.34 ± 1.51 years. Majority of the females i.e. 43 (58.11%) were between 6 months to 3 years of age. Out of these 74 patients, 45 (60.81%) were male and 29 (39.19%) were females with male to female ratio of 1.6:1. In my study, frequency of pain relief, using FLACC scores was found in 65 (87.84%) pediatric patients undergoing thoracotomy for congenital heart diseases with caudal anesthesia. Conclusion: This study concluded that the frequency of pain relief, using FLACC scores, in pediatric patients undergoing thoracotomy for congenital heart diseases with caudal anesthesia is very high.