Evaluation of the perioperative analgesic effects of caudal block for herniotomy in children at the University College Hospital Ibadan, Nigeria.

Background: Caudal block is a commonly performed day case anaesthetic procedure in children for most infraumbilical surgeries worldwide [1] as it provides good analgesia in the perioperative period. In Nigeria there is paucity of data on caudal block hence the justification for this study.

Methods: This study compared the perioperative analgesic effects and safety profile of caudal block using 0.5 ml/kg body weight of 0.25% plain bupivacaine with light general anaesthesia (GA) versus inhalational GA alone in 60 children aged 2-10 years that had herniotomy using behavioural pain scale to access pain [2].

Results: Showed a mean duration of surgery +/-standard deviation (SD) of 17 +/- 2 minutes for caudal, 51 +/- 6 minutes for GA (t = 60, p < 0.05, df = 59). Mean recovery times postoperatively was 6 +/- 2 minutes for caudal, 14 +/- 3 minutes for the GA (t =14, P < 0.05, df = 59). Mean postoperative pain scores was 2 +/- 0.6 for caudal, 5 +/-1 for the GA (t = 4, p < 0.05, df = 9). Time to first analgesic requirement was 170 +/- 19 minutes, 39 +/- 4 minutes for caudal and GA groups respectively (t = 37, p < 0.05, df = 59). Postoperatively 60% and 0% of patients in GA and caudal groups required opioid analgesic respectively.

Conclusions: Children who had herniotomy under caudal block with 0.5 ml/kg of 0.25% plain bupivacaine had good analgesia with minimal complications. Caudal block in children is easy to perform and it's suitable for most day case infraumbilical surgeries.