Caudal Block with General Anesthesia for Outpatient Pediatric Surgery Procedures

Abstract

Background: Pediatric surgery is mostly done in an outpatient setting and due to this fact preoperative and postoperative pain management is a very important task to overcome. Aim:We aim to share and underline our clinical experience regarding with the children's comfort and parents' satisfaction after outpatient pediatric surgery cases performed under general anesthesia combined with caudal block regional anesthesia. Methods:The files of 405 ASA1 outpatient pediatric surgery patients were retrospectively reviewed. Each inguinoscrotal procedures performed under general anesthesia combined with caudal extradural 1ml/kg bupivacaine. Caudal extradural block was performed just after general anesthesia induction just before the operation. The objective pain score was used to determine child analgesia requirement level postoperatively up to 12 hours. Postoperative pain control was sustained for 48 hours using routine paracetamol and ibuprofen if needed.Results: Combined anesthesia and caudal block during outpatient procedures leads usage of low dose of inhalation anesthetic requirement and early recovery from the anesthetic condition. This was achieved by effective pain control of caudal block. The main concentration of caudal block performed according to the types of outpatient procedures. In hypospadias patient bupivacaine concentration were kept at high level aim to prolong lower extremities immobilization for better recovery. Combined anesthesia with caudal block for outpatient procedures made possible to discharge all most all of the patients as day case surgery. Conclusion:Combined general anesthesia with caudal analgesia with bupivacaine enable us effective and safe per operative pain control beside usage of lower dose of inoperative anesthetic agents makes day case surgery more safer for children with less side effects.