Evaluation of the perioperative analgesic effects of caudal block for herniotomy in children at the University College Hospital Ibadan, Nigeria

Abstract

Introduction: Caudal block is a commonly performed day case anaesthetic procedure in children for most infraumbilical surgeries worldwide (1) as it provides good analgesia in the perioperative period. In Nigeria there is paucity of data on caudal block hence the justification for this study. Methods: This study compared the perioperative analgesic effects and safety profile of caudal block using 0.5 ml/kg body weight of 0.25% plain bupivacaine with light general anaesthesia (GA) versus inhalational GA alone in 60 children aged 2-10 years that had herniotomy using behavioural pain scale to access pain (2). Results: Showed a mean duration of surgery ± standard deviation (SD) of 17±2 minutes for caudal, 51 ± 6 minutes for GA (t = 60, p < 0.05, df = 59). Mean recovery times postoperatively was 6 ± 2 minutes for caudal, 14 ±3 minutes for the GA (t=14, P < 0.05, df=59). Mean postoperative pain scores was 2 ± 0.6 for caudal, 5 ±1 for the GA (t=4, p < 0.05, df=9). Time to first analgesic requirement was 170± 19 minutes, 39±4 minutes for caudal and GA groups respectively (t=37, p < 0.05, df=59). Postoperatively 60% and 0% of patients in GA and caudal groups required opioid analgesic respectively. Conclusion: Children who had herniotomy under caudal block with 0.5ml/kg of 0.25% plain bupivacaine had good analgesia with minimal complications. Caudal block in children is easy to perform and it's suitable for most day case infraumbilical surgeries.