title: [Control of postoperative bladder spasm by caudal anesthesia in children undergoing ureteral reimplantation].
abstract: BACKGROUND
  For management of postoperative bladder spasm by the ureteral reimplantation, general anesthesia and epidural anesthesia are selected in many hospitals, but epidural anesthesia is not a common technique for various complications and risks. We examined whether postoperative bladder spasms can be prevented by general anesthesia combined with single shot caudal anesthesia.
  
  
  METHODS
  We studied 18 patients undergoing ureteral reimplantation. Premedicated by diazepam syrup (0.5 mg x kg(-1), maximum dose 10 mg). In combination with caudal anesthesia with 0.3% ropivacaine (3 mg x kg(-1), maximum dose 60 mg), general anesthesia was maintained with oxygen, nitrous oxide and sevoflurane. For the evaluation of pain relief we used face pain scale when the patients returned to the ward, postoperative 5 hours, 24 hours and at discharge.
  
  
  RESULTS
  At postoperative 5 and 24 hours, some patients had a pain scale of above 3. But, those under pain scale 1 was 83%. At discharge, all patients were evaluated as pain scale 0 or 1.
  
  
  CONCLUSIONS
  General anesthesia combined with single shot caudal anesthesia suppressed postoperative bladder spasm. All patients were discharged within 3 postoperative days.
authors.affiliation: Department of Anesthesiology, Dokkyo Medical University Koshigaya Hospital, Koshigaya 343-8555.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Maki
authors.initials: M
authors.lastname: Yamada
authors.forename: Takero
authors.initials: T
authors.lastname: Arai
authors.forename: Hisashi
authors.initials: H
authors.lastname: Inoue
authors.forename: Akemi
authors.initials: A
authors.lastname: Ichiki
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Okuda
authors.forename: Asako
authors.initials: A
authors.lastname: Yasuoka
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakai
mesh_terms: D000763:Anesthesia, Caudal; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012092:Replantation; D013035:Spasm / Q000517:prevention & control*; D014513:Ureter / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000517:prevention & control*