title: Comparison of caudal block using bupivacaine and ketamine with ilioinguinal nerve block for orchidopexy in children.
abstract: Forty boys weighing less than 25 kg undergoing unilateral orchidopexy were randomly allocated to receive one of two analgesic regimens. Group C received a caudal epidural block with 0.25% bupivacaine 1 ml.kg-1 and preservative-free ketamine 0.5 mg.kg-1; Group L received an ilioinguinal nerve block with 0.25% bupivacaine 0.5 ml.kg-1 and infiltration of the wound with 0.25% bupivacaine 0.5 ml.kg-1. All subjects received diclofenac sodium 1-2 mg.kg-1 as a rectal suppository. Postoperative pain was assessed by means of a modified Objective Pain Score and analgesia was administered if this exceeded a value of 4. The median duration of analgesia was 10 h (range 2.6 to > 24 h) in Group C and 2.9 h (range 0.7 to > 24 h) in Group L (p < 0.05). There were no differences between groups in the incidence of motor block, urinary retention, postoperative vomiting or postoperative sedation. Subjects in Group L required significantly more doses of postoperative analgesia than those in Group C (p < 0.05).
authors.affiliation: Department of Anaesthesia, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: D
authors.initials: D
authors.lastname: Findlow
authors.forename: L M
authors.initials: LM
authors.lastname: Aldridge
authors.forename: E
authors.initials: E
authors.lastname: Doyle
mesh_terms: D000082:Acetaminophen; D018712:Analgesics, Non-Narcotic; D000763:Anesthesia, Caudal; D000768:Anesthesia, General; D019162:Anesthetics, Combined; D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D002045:Bupivacaine; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D007649:Ketamine; D008297:Male; D009407:Nerve Block; D010149:Postoperative Pain / Q000517:prevention & control*
chemical_list: D018712:Analgesics, Non-Narcotic; D019162:Anesthetics, Combined; D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D000082:Acetaminophen; D007649:Ketamine; D002045:Bupivacaine