The management of postoperative pain in children with caudal blocks
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Background: The aim of this study was to evaluate the pre-emptive analgesic effect and duration of postoperative analgesia after caudal blocks in children. Method: Forty-five children undergoing distal hypospadias surgery were assigned to group 1 (n=23), and received caudal 0.25\% bupivacaine 0.5 mg/kg and midazolam 0.05 mg/kg before the surgical incision. Group 2 (n=22) received caudal 0.25\% bupivacaine 0.5 mg/kg and midazolam 0.05 mg/kg at the end of surgery. Anaesthesia was induced with propofol and fentanyl and maintained with sevoflurane and nitrous oxide. Postoperative pain was rated on an objective paediatric pain scale. Results: The analgesic requirement was greater in the second group. Conclusion: Pre-emptive analgesia with caudal blocks may prevent the intensity and frequency of postoperative wound pain. (C) SASA