Postoperative Pain Scores and Rescue Analgesic Requirements in Children Undergoing Infraumbilical Surgery

Background: Effective postoperative analgesia is essential in children undergoing infraumbilical surgery. The choice of anadjuvant to caudal ropivacaine may influence pain intensity, duration of analgesia and the need for additional medication.The aim is to compare postoperative pain scores, duration of analgesia and safety outcomes in children receiving ropivacainewith clonidine or tramadol. Materials and Methods: This prospective, randomized, double-blind comparative study included60 children aged 3–10 years undergoing infraumbilical surgery. Participants were allocated to Group RC, receiving 0.25%ropivacaine (1 ml/kg) with clonidine (1 μg/kg), or Group RT, receiving 0.25% ropivacaine (1 ml/kg) with tramadol (1 mg/kg).Postoperative pain was assessed using the Observer Pain Score at scheduled intervals. Duration of analgesia and recordedadverse events were compared between groups. Results: Each group included 30 children. Mean recorded pain scores weresimilar at one hour (1 versus 1) and two hours (2 versus 2). At four hours, scores were 2 in Group RC and 3 in Group RT; ateight hours, they were 3 and 4, respectively. Both groups had a score of 4 at 12 hours. Mean duration of analgesia was 889.97± 119.19 minutes in Group RC and 657.97 ± 114.03 minutes in Group RT, a difference of 232 minutes. Hypotension,bradycardia, nausea and vomiting were reported in both groups; these frequencies require verification against the originalrecords. Conclusion: The available results suggest longer analgesia and lower intermediate postoperative pain scores withropivacaine–clonidine. Verified statistical analyses and rescue-analgesic consumption data are needed before definitiveconclusions can be drawn.