Analgesic efficacy of single shot caudal block for circumcision

ABSTRACT

To assess the usefulness of caudal epidural block with bupivacaine for postoperative analgesia after circumcision in children at Children Hospital complex Multan. This study was earned out in Children Hospital Complex Multan from March 2008 to December 2008. One hundred boys, aged 2 to 10 years, ASA 1 status scheduled for elective circumcision. They received caudal epidural block with bupivacaine 0.25%, 0.5ml.kg-1, after induction of general anesthesia and studied for postoperative pain relief. Patients were excluded if they had local infection, preexisting neurological disease, bleeding diathesis or any analgesic ingestion in the preceding week.. Post-operative pain was assessed by Facial expression scale in small children. In older children pain assessment was done by clinical observation, by asking about pain and by dynamic pain score. Mean duration of analgesia was 10.43 +/- 3.4 hours. Time for micturition was 161.79 +/- 83.2 minutes while time to stand was 161.21 +/- 69.65 minutes. Hemodynamic and respiratory parameters remained stable during the observation period. Frequency of postoperative nausea and vomiting was 12% while urinary retention occurred in 2% patients. Caudal epidural block with bupivacaine 0.25% in a dose of 0.5 ml/kg-provides safe and effective postoperative pain relief in children undergoing circumcision and penile surgery, with very few complications