The effect of pre-emtive caudal block on postoperative pain in children

OBJECTIVE: The aim of this study is to investigate the effectof preoperative and postoperative caudal block and the need for analgesics on postoperative pain in children undergoing inguinal operation.

STUDY DESIGN: We investigated postoperetive pain after inguinal hernia operation in 50 children of ASA 1,aged between 3 and 8 years old. 30 minutes before surgery, after sedation obtained by administration of 0.7 mglkg ot rectal midaýolam, the first group of patients (n=25) recieved­ caudal block with 0.5 ml!kg of %0.25 bupivacain and 20 minutes later, they had general anesthesia. The second group of patients was submitýed ro the same protocole but received caudal block at the end of the surgery.
During eight hours after surgery, the pain was rated eveýy 30 minutes using POPS. Thýe parents of patients were told to noýice the time ot the given analgesics in the 48 hours postoperatively.
The Mann-Whitney U test was used for statistical analysis of our findings. p<0.05 was considered stcatistically signifanct.

RESULTS: During 8 hours postoperatively tlýe pain score was significantly lm-vý: r (p<0.05) in the first group, while there was no statistically significant difference (p>0.05) between the 2 groups in the 48 hours postoperative follow­ up.

CONCLUSIONS: in pediatric inguinal hernia operations the "pre-emptive" analgesia obtained by caudal block lowers the postoperative pain score during the first 8 hours after surgery but there is no effect on the need for analgesics in the 48 hours postoperative period.

Çocuklarda Preemtif Kaudal Bloğun Postoperatif Ağrý Üzerine Etkilerinin İncelenmesi

AMAÇ: Bu çalýşmada inguinal herni operasyonu uygulanan çocuklarda pre ve postoperatif dönemde yapýlan kaudal bloðun postoperarit aðrý ve analjezik ihtiyacý üzerine etkilerini incelemeyi amaçladýk.
MATERYAL VE METOD: Yaşlarý 3 ile 8 arasýnda, ASA I grubýuna dahil 50 olgu üzerinde çalýşýldý. Birinci gruba (n=25) operasyondan 30 dakika önce 0.7 mgfkg rektal midazohým ile sedasyon sağlandýktan sonra 0.5 mllkg %0.25 bupivakain ile kaudal blok yapýldý. 20 dakika sonra anestezi verildi. İkinci grup hastalara da ayný anestezi uygulandý, ancak bu gruba kaudal blok operasyon sonunda yapýl­dý. Postoperatif dönemde hastalarýn ağrý düzeyleri POPS'a göre 8 saat boyunca her 30 dakikada bir değerlendirildi. Ebeveynlerden postoperarif ilk 48 saat içinde çocuklarýna analjezik verme zamanlarný kaydetmeleri istendi. İstatistiksel deðerlendirmeler Mann-Whitney U testi ile yapýldý. p<0.05 cm/anýlý kaimi edildi.
BULGULAR: Postoperetif ilk 8 saatteki aðrý skoru, birinci grupta anlamlý olarak düşük bulundu(p<0.05). Postoperatif 48 saatteki rakiplerinde iki grup arasýnda anlamlý bir fark bulundu (p>0.05).
SONUÇ: Pediyatrik inguinal herni operasyonlarýnda kaudal blokla pre-emptif analjezinin postoperatif ilk 8 saatte aðrý skorunu düşürdüðü, fakat 48 saatlik takiplerde analjezik ihtiyacýný azaltmadýðý görüldü.