Caudal epidural for postoperative analgesia in male children

Objective: To assess the duration and safety of single dose caudal epidural with bupivacaine for postoperative analgesia in children

Design: A descriptive study

Setting: Chandka Medical College Hospital, Larkana from February 2002 to September 2004

Patients and Methods: One hundred and seventy six boys, ASA-I, between the ages of 2 to 8 years, scheduled for inguinal or penile surgery, were randomly assigned in a prospective fashion to receive single shot caudal epidural with bupivacaine 0.25%, 0.75ml.kg-1, and studied for postoperative pain relief. Pain was evaluated by using faces pain scale. Analgesia was administered when pain scale was 3-4. Postoperative complications were also noted

Results: Mean duration of analgesia was 10.43 +/- 3.4 hours. Time for micturation was 161.79 +/- 83.2 minutes while time to stand was 161.21 +/- 69.65 minutes. Haemodynamic and respiratory parameters remained stable during the observation period. Frequency of postoperative nausea and vomiting was 7% while urinary retention occurred in 1.4% patients

Conclusion: Caudal epidural analgesia with bupivacaine 0.25% in a dose of 0.75ml.kg-1 provides safe and effective postoperative pain relief in children undergoing inguinal and penile surgery, with very few complications

Malrotation of the intestine

This is a study of 15 patients of malrotation operated in the Department of Paediatric Surgery, Chandka Medical College Hospital Larkana, between January 1996 to June 2000. The patients were divided into three age groups: newborns [3], infants [7] and older children [5] because of the difference in their clinical presentations. Associated anomalies were present in 2 patients [13.3 percent]. Upper GI study was the main diagnostic investigation. All patients underwent laparotomy. Resection and anastomosis was done in one newborn with volvulus and necrosis of bowel; Ladd's procedure was carried out in all other patients without appendectomy. Postoperative recovery was quicker in older children. Postoperative complications occurred in 4 patients [27 percent] and 14 patients got total relief of symptoms; only one patient had persistent GI symptoms even after surgery. There was no mortalty in the series. Follow up ranged from 3 months to 3 years

Atypical conjoined twins: a case report and review of classification

Conjoined twins which are incomplete are labeled as atypical conjoined twins. Though the classification of typical conjoined twins is more or less standardized, that of atypical conjoined twins is still not very clear and uniform. We present here a case of successfully separated atypical conjoined twins, pygopagus parasiticus and brief review of various classifications of conjoined twins

Gastric teratoma: a case report with review of literature

Gastric Teratoma is a benign tumour that occurs rarely. Following is the report of such a case in a six months old infant who presented with an abdominal mass with multiple abscesses. He was successfully treated by performing partial gastrectomy with complete removal of the tumour