Evaluation of caudal epidural analgesia for relieving post-operative pain in perianal, inguinoscrotal and urethral surgery in paediatric age group

Abstract

Background: Post-operative pain poses special problems in children. The use of caudal epidural analgesia for post-operative pain relief, either completely eliminates or appreciably reduces the hazards of narcotic analgesics. So, this study was planned to clinically evaluate the efficacy, safety and duration of pain relief following caudal epidural analgesia in children. Materials & Methods: This prospective study was conducted in children from age group 0 to 12 years undergoing perianal and genital surgery after taking permission from institutional ethics committee. Patients with sacral anomalies, skin infection, poor bony land marks, movements and previous operation were not included in study. 1% lignocaine hydrochloride was used with adrenaline in concentration of 1:2000000 for caudal analgesia Children were observed for pain as well as for any untoward effects in post-operative period. Results: In this study caudal block was successful in 48 (96%) cases out of total 50 surgical patients who were recruited during the study period. The duration of pain relief ranged from 265 minutes to 500 minutes. The average duration was 394 minutes. Haematoma and Blood in epidural tap were observed in 4% and 8% cases respectively. Retention of urine was recorded in 4% cases. Pain at injection site was complained by 12% cases. Nausea and vomiting was recorded in 20% cases. Conclusion: It is concluded that caudal block is an efficient and safe method for achieving pain relief of reasonable duration during post-operative period in children. Key Words: Post-operative pain, perianal and genital surgery, caudal epidural analgesia, narcotic analgesics, lignocaine