title: Caudal epidural anesthesia reduces blood loss during hypospadias repair.
abstract: We studied 24 boys who were randomized to receive caudal epidural anesthesia with 0.33 ml.kg.-1 0.25% bupivacaine either before (group A) or after (group B) Mathieu repair of distal hypospadias. The 2 groups did not differ in regard to age or weight, and all boys received a standardized anesthetic with halothane and nitrous oxide in oxygen. Intraoperative blood loss was measured with sponge weights and microcalibrated suction canisters. Halothane requirements were reduced in group A (0.5 versus 1.1 plus or minus 0.1%, p less than 0.001). Measured blood loss was reduced in group A (16 plus or minus 10 ml. versus 31 plus or minus 17 ml., p less than 0.01). Operating time was reduced in group A (92 plus or minus 13 minutes versus 103 plus or minus 14 minutes, p less than 0.05). There was no apparent difference in postoperative pain relief between the 2 groups. We conclude that caudal epidural anesthesia can reduce blood loss and improve surgical conditions during hypospadias repair.
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: J B
authors.initials: JB
authors.lastname: Gunter
authors.forename: J E
authors.initials: JE
authors.lastname: Forestner
authors.forename: C B
authors.initials: CB
authors.lastname: Manley
mesh_terms: D000763:Anesthesia, Caudal; D000767:Anesthesia, Epidural; D000769:Anesthesia, Inhalation; D002045:Bupivacaine; D002675:Child, Preschool; D006221:Halothane; D006488:Hemostasis, Surgical; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation
chemical_list: D006221:Halothane; D002045:Bupivacaine