Caudal Anesthesia for Postoperative Pain Control in Pediatric Urologic Patients

Lee, Sang Ryull; Yoo, Hee Koo

Abstract

In this study, caudal anesthesia was performed with 0.25% bupivacaine and 0.25% bupivacaine-1% lidocaine mixtures at the end of operation. Anesthetics were administered randomly with the volume of 0.5 ml/kg, 0.75 ml/kg, 1.0 ml/kg and 1.25 ml/kg individually. The results were as following: 1) The more the volume of loeal anesthetics administered, the higher the spinal dermatome was blocked(P<0.005) and adequate analgesic levels were achieved. Body height classification by under and over 100 cm does not have statistically significant to determined of local anesthetic dosage. 2) Volume of local anesthetic solution required to block a spinal segment and body weight was most correlated to each other. At least 0.75 ml/kg or 1.0 ml/kg of local anesthetics are average amount for adequate pain control of pediatric urologic patients. 3) Only 17(24%) in 70 patients were required additive analgesic during postoperation 24 hours. 4) Local anesthetic volume required to block per a spinal segment was gradually increased with increased age and it markedly increased from 7 years old patients, this results have statistically significant correlationship. 5) The average volume of local anesthetic solution in patients under and over 100 cm in body height were 0.95+/-0.235 ml/spinal segment and 1.576+/-0.443 ml/spinal segment respectively(P< 0.0005). 6) Analgesic duration did not depend on operation site and body height(cm), analgesic duration tend to prolonged a little in patients who had undergone penoscrotal operation. 7) There was no statistical difference in analgesic durations between 0.25% bupivacaine group and 0.25% bupivacaine-1% lidocaine mixture group. With above results, we suggest that caudal analgesia in pediatric urologic patients who had undergone inguinal or penoscrotal operation would be simple, safe and effective method for postoperative pain relief.