Early Postoperative Analgesia Effect of Caudal Block in Children With Hypospadias Repair Surgery

Objective To observe the early postoperative analgesia effect of caudal block in children with hypospadias repair surgery. Methods From January to December 2010, 38 children who accepted hypospadias repair surgery and required postoperative analgesia were included in this study. They were randomly divided into research group(general anesthesia combined with caudal block, n=20) and control group(general anesthesia, n=18). The volume of local anesthetics was 0.8 mL/kg, of which 1/3 was 1% lidocaine and 2/3 was 0.2% ropivacaine, separately prepared and injected. In addition, continuous intravenous infusion of remifentanil were added to control group. During the operation, 2-3% sevoflurane inhalation and continuous intravenous infusion of propofol [3 mg/(kg·h)] were given for maintaining sedation in both groups, and all patients received tramadol patient controlled analgesia(PCA). The vital signs during operation, the FLACC pain score, sedation scale, and adverse reactions in 48 h after operation were recorded and assessed.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Hospital of Sichuan University.Informed consent was obtained from each parents. Results There had no significant difference in general condition and vital signs during the operation between two groups(P>0.05). The component ratio of the children whose FLACC scores were less than 4 points and Ramsay sedation score in research group was obviously higher than that in control group in post anesthesia care unit(PACU) (P 0.05). The incidence of restlessness in research group was lower than that in control group (P 0.05). Conclusions Caudal block not only can provide satisfying early postoperative analgesia effect for children with hypospadias repair surgery, but also reduce analgesic requirements after operation. Key words: caudal block; general anesthesia; tramadol; postoperative analgesia; hypospadias; child