الملخص
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.
Keywords: Caudal block, general anaesthesia, herniotomy, children
Résumé
Introduction : Le bloc caudal est un cas de procédure d’anesthésie fréquemment réalisée chez les enfants pour la plupart des chirurgies sous-ombilicale dans le monde entier, car il fournit une bonne analgésie pendant la période péri opératoire. Au Nigeria, il ya peu de données sur le bloc caudal d’où la justification de cette étude.
Méthodologie: Cette étude a comparé les ef fets analgésiquespéri opératoi res etle profi ldesécuri té dubloccau dal enu til isant0,5ml/ kgdepoids corpor eld ebupivacaïne0,25%brut av ec l’ anest hési e générale légère(AG) contre l’inhalationGAseul c hez60en fant sâgésde2–10ansquiavaientl’ herniotomie uti l isantl’échel le dedouleur comportementalepour évalue rladouleur.11
Résultats: Les résultats ont montré une durée moyenne de la chirurgie caudale de 17 ± 2 minutes (déviation standard (SD), 51 ± 6 minutes pour GA (t = 60, p< 0,05, df = 59). La durée moyenne de rétablissement Caudal postopératoire était de 6 ± 2 minutes, 14 ± 3 minutes pour le GA (t = 14, P< 0,05, df = 59). Les scores de douleur postopératoire étaient de 2 ± 0,6 pour caudale, 5 ± 1 pour le GA (t = 4, p< 0,05, df = 9). Impression de la première demande d’analgésique était de 170 ± 19 minutes, 39 ± 4 minutes pour les groupes caudale et GA respectivement (t = 37, p<0,05, df = 59). Après l’opération 60% et 0% des groupes de patients GA et caudal avaient besoin des opioïdes analgésiques respectivement. Les enfants qui avaient herniotomie sous anesthésie caudale avec 0.5ml/kg de bupivacaïne 0,25% brut avaient une bonne analgésie avec un minimum de complications.
Conclusion: Le bloc caudal chez les enfants est facile à réaliser et il est adapté à la plupart des cas quotidien de chirurgie sousombilicale.
Correspondence: Dr. Akinyemi, O. Akinola, Department of Anaesthesia, College of Medicine, University of Ibadan, PMB 5116, Ibadan, Nigeria. E-mail: oluakinakinyemi@yahoo.com
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