title: [Caudal anesthesia combined with general anesthesia in comparison with general anesthesia in ambulatory circumcision].
abstract: In 100 boys (5.9 +/- 3.2 years old) undergoing outpatient circumcision, analgesia was provided with 0.375% bupivacaine 1 ml/year of age by caudal injection (group I), administered after induction of general anesthesia. This group was compared with 100 boys (6.3 +/- 3.4 years old), who received only general anesthesia (group II). The puncture technique described was free of complications and the caudal blocks were 98% successful. There was a great difference with regard to the levels of general anesthesia: the average enflurane concentrations required to block autonomic reactions during surgical intervention was 1.3 vol% in group I and 2.7 vol% in group II. The amount of pethidine needed for perioperative pain relief was 8 mg (+/- 5.7) in 17/100 of group I and 17.3 mg (+/- 6.8) in 91/100 of group II. In addition, paracetamol was given in 10/100 of group I and 30/100 of group II. The boys in group I showed calm postoperative behavior. In both groups there were only slight differences in hemodynamic parameters. Of the parents who answered our questionnaire (50 answers to 60 questionnaires), 68% were amazed at the duration of analgesia. During the late postoperative period, in group I there was an almost total absence of vomiting (4%), with an associated rapid return to normal feeding. In 83% the effect of late postoperative analgesia worked so well that no subsequent analgesic was given. In 15% the pain relief lasted 6.3 +/- 2.5 h. The excellent postoperative pain relief produced by caudal anesthesia justifies its frequent use for children subjected to genital surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Institut für Anaesthesiologie, Städtischen Kliniken Osnabrück.
authors.forename: G
authors.initials: G
authors.lastname: Grosse
mesh_terms: D000082:Acetaminophen; D000556:Ambulatory Surgical Procedures; D000763:Anesthesia, Caudal; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D002045:Bupivacaine; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male; D004737:Enflurane; D006801:Humans; D008297:Male; D008614:Meperidine
chemical_list: D000082:Acetaminophen; D004737:Enflurane; D008614:Meperidine; D002045:Bupivacaine
vernacular_title: Kaudalanaesthesie kombiniert mit Allgemeinanaesthesie im Vergleich zur Allgemeinanaesthesie bei ambulanten Zirkumzisionen.