COMPARISON OF ANALGESIC EFFECTS BETWEEN THORACIC EPIDURALAND INTRAVENOUS ANALGESIA IN TERMS OF MANAGEMENT OF POSTOPERATIVE PAIN RELIEF IN CONGENITAL CARDIAC SURGICAL PATIENT IN PAEDIATRIC POPULATION.

Regional analgesia techniques are a safe and effective alternative than IV for post operative pain relief. Aim is to compare analgesic efficacy between thoracic epidural and intravenous analgesia in terms of management of postoperative pain relief in congenital cardiac surgical population. 60 CHD patients between 1 month to 12 years included in prospective observational study divided into Group TEA (n = 30); Group IVA (n = 30). Group TEA received continuous epidural with 0.1% bupivacaine + 0.0006% fentanyl @ 0.8 mL/hour +0.05 mL .Gr IVA received continuous intravenous fentanyl infusion at 1–2 mcg/kg/h.Intravenous paracetamol 15-30 mg/kg used as rescue analgesia. HR, SBP, DBP, MAP, Wong Baker FACES pain rating scale monitored and analysed. Age sex weight, height, and BMI, mean onset of pain after extubation were comparable. The SBP was significantly lower in Group TEA than Group IVA at 12 post extubation hours, 72 hours and 96 hours (p=0.044, 0.012 and 0.004 respectively. MAP was significantly lower in Group TEA than Group IVA at 96 hours (p=0.028). The Wong Baker FACES pain rating scale was significantly lower in Group TEA than Group IVA at 48 hours and 60 hours (p=0.012 and 0.033 respectively). Rescue analgesia needed in TEA group was 4 (13.3%), and in IVA group 11 (36.7%). and was statistically significant (0.037). Occurrence of nausea and somnolence was similar (p=0.640 and 0.228 respectively) incidence of vomiting was significantly higher in IVA (p=0.044). To conclude TEA provided better pain relief with significantly decreased requirement of postoperative analgesia.