Abstract
The objectives of this study are to compare caudal analgesia supplemented by sedation with general anaesthesia technique and to study the relative safety and difficulties of each technique on the patient and its benefit. A prospective study on 90 patients was performed. These patients required anorectal surgery within a period of 6 months from May-Nov. 1998. Divided into 2 groups, there were 45 operations performed under CA, and 45 operations under GA at King Hussein Medical Centre (KHMC) and Prince Hashim ben Al-Hussein Hospital (PHH) RMS JA Forces. General anaesthesia group showed uneventful course, but at the end of surgery restlessness during recovery was seen in 10 patients, demand for analgesia in 70% patients which was particular to that group. Caudal anaesthesia group: absolute failure to institute the block occurred in 4 patients in whom general anaesthesia was given. Relative difficulties were encountered in 3 patients, but the block was complete after repeated trials. O2 commenced at a rate of 4 liters/minute through oxygen mask was needed for 3 cases of mild respiratory depression. Table II showed anaesthesia for various operations and the sex distribution. The view of the patients in regard to the technique employed is demonstrated in Table III and in regard to the post operative pain is shown in Table V. Caudal anaesthesia was a useful technique when supplemented by intravenous sedation which gave sedation during the operation period and delayed onset of post operative pain
Highlights
Caudal analgesia for ano-rectal surgery was a neglected method
Caudal and general anaesthesia to study the acceptability of the technique by the patient and its benefit
Fourteen percent failure rate was observed in the caudal group, 5% needed general anaesthesia, 10 % either difficult anatomy or more than one cause
Summary
Caudal analgesia for ano-rectal surgery was a neglected method. Recent interest in its analgesic properties, and the avoidance of all the complications of general anaesthesia stimulated us to reevaluate its application.During the last six months, a prospective comparative randomized trial betweenCorrespondence to: Dr Omar S. Blood pressure reduction more than 30mmHg below the pre anaesthesia was recorded in 4 patients (5%)
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