Pediatric Caudal Anesthesia Using 1 % Sidocaine and 0.25 % Bupivacaine

Cheun, Jae Kyu; Choi, Kyu Taek; Kim, Seong Sik

Abstract

Pediatric caudal anesthesia appears to be a safe and reliable technique for surgical procedures below the umbilicus. Advantages of caudal anesthesia in infants and children include the simplicity of the technique, the high success rate, the post operative pain relief and the rare complication rate. The aim of this study was to determine an ideal local anesthetic agent and its dosage for clinical practice in pediatric caudal anesthesia. Caudal anesthesia was given to 97 patients who were divided into three groups. Group I was given 1% lidocaine l ml/kg, Group 2 was given 1% lidocaine 0.7 ml/kg and Group 3 was given 0.25% bupivacaine 1 ml/kg. All caudal blocks were carried out in the left lateral position after thiopental 4-5 mg/kg iv or under general anesthesia with halothane. The duration of anesthesia, the side effects during and after operation, the post operative pain score, motor activity, and sensory level were observed and compared among the three groups. As the result of this study, we think that caudal anesthesia using 1% lidocaine and 0.25% bupivacaine is a safe, simple and practical method in clinical practice for infants and children. The duration of anesthesia ranged from 60 to 120 minutes, and side effects were rare and insignificant. The patients position for caudal blocks was most suitable in the left lateral position. We came to the conclusion that the use of 1% lidocaine 1 ml/kg is most practical in safe practice of pediatric caudal anesthesia and 1% lidocaine 0.7 ml/kg and 0.25% bupivacaine l ml/ kg can be recommended depending on the surgical locations and required time for surgical procedures.