Key result
Pre-emptive caudal bupivacaine and midazolam reduces postoperative analgesic requirements versus post-surgery administration.
Why the study?
The study aimed to evaluate the pre-emptive analgesic effect and duration of postoperative analgesia after caudal blocks in children undergoing surgery.
Does pre-emptive caudal block with bupivacaine and midazolam reduce postoperative pain and analgesic requirement in children undergoing distal hypospadias surgery?
RCT (n=45)
Does pre-emptive caudal block with bupivacaine and midazolam reduce postoperative pain and analgesic requirement in children undergoing distal hypospadias surgery?
Pre-emptive analgesia with caudal blocks may prevent the intensity and frequency of postoperative wound pain in children undergoing hypospadias surgery.
Answers are grounded in this paper and cite their sources.
May support pre-emptive caudal analgesia in children; leaves open confirmation in larger randomized trials.
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.
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Hasani et al. (2011) conducted an RCT in Distal hypospadias (n=45). Pre-emptive caudal block (bupivacaine and midazolam) vs. Caudal block at the end of surgery was evaluated on Analgesic requirement. Pre-emptive analgesia with caudal bupivacaine and midazolam before surgical incision reduced postoperative analgesic requirements compared to administration at the end of surgery.
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