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Abstract

 BACKGROUND:Caudal block is the commonest regional technique in pediatric patients. It provides excellentanalgesia with minimal side effects. It is typically combined with general anesthesia. There are anumber of advantages to this practice because anesthetic depth can be reduced by regionalanesthesia, thereby potentially reducing the complications of both forms of anesthesia. It iscommonly used for procedures below the umbilicus.OBJECTIVE:The aim of the study is to evaluate the effect of caudal block in reducing the anestheticrequirement when it is combined with general anesthesia and its effect on the recovery period.PATIENTS AND METHOD:Forty healthy unpremedicated children, ASA Ӏ, aged (2-5 years) undergoing inguinal herniarepair, were randomized to either Caudal group [using 1ml/kg of 0.25% bupivacaine] (n=20), orcontrol group ( without caudal block) (n=20). In both groups anesthesia were induced andmaintained with halothane, the vital signs were recorded ( heart rate, respiratory rate) every 5minutes, and according to stability of the vital signs the inspired halothane concentration wasfollowed. We also compared the recovery in both groups.RESULTS:At surgical incision; in group 0 [ control], there were increases in heart rates [15-20%] and inrespiratory rates [6-8%] from zero time, while in group1 [caudal], the heart rates increased onlyby [ 2-3%] and respiratory rates by [1-2%]. After 15 min. from zero time, the vital signsremained around the zero time in group 0; while in group 1 the vital signs decreased below thezero time by [13-14%]. At 30 minutes there was further fall in the vital signs in group1 [16%], sowe decreased inspired halothane concentration to 0.6 till the end of surgery. In group 0, themeasurements remained around the zero time or just slightly changed [less than 5%], whileinspired halothane concentration remained at 1.1% till the end of surgery. The recovery ingroup1 was smoother and faster than in group 0 with lesser complications .CONCLUSION:Caudal block using 1ml/kg of 0.25% bupivacaine, when combined with general anesthesia foringuinal herniotomy in pediatric age group, is sufficient to reduce the halothane requirement[MAC]intraoperatively and insures smoother and faster recovery without any major airway-relatedcomplications or hemodynamic instability.

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