TY - JOUR
T1 - Postoperative voiding interval and duration of analgesia following peripheral or caudal nerve blocks in children
AU - Fisher, Q. A.
AU - McComiskey, C. M.
AU - Hill, J. L.
AU - Spurrier, E. A.
AU - Voigt, R. E.
AU - Savarese, A. M.
AU - Beaver, B. L.
AU - Boltz, M. G.
PY - 1993
Y1 - 1993
N2 - We studied the time to postoperative micturition and the duration of analgesia in 82 children aged 6 mo to 10 yr undergoing herniorrhaphy or orchiopexy under general anesthesia with N2O and halothane. All received D5 lactated Ringer's solution equivalent to 6 h maintenance intraoperatively, and oral fluids postoperatively ad libitum. At the end of surgery, patients were randomly assigned to receive one of three regional anesthetic injections using 0.25% bupivacaine: caudal, 0.75 mL/kg (group I); caudal with 1:200,000 epinephrine, 0.75 mL/kg (group II); or ilioinguinal-iliohypogastric nerve block with epinephrine through the wound by the surgeon (group III). Postoperatively, blinded observers scored pain at 30 min, hourly until discharge, and by telephone at 24-36 h. In the 74 patients with successful blocks (mean age 2.5 ± 2.4 yr), the times to micturition (group I, 202 ± 130 min; group II, 262 ± 164 min; group III, 196 ± 101 min) did not differ significantly among groups. Seven patients who took more than 8 h to void required no intervention. There was no difference in the numbers without pain for ≥4 h (74%, 64%, and 69% of groups I, II, and III), or those requiring analgesics by 24 h (66% overall). The time to postoperative voiding in children is variable and not prolonged by caudal analgesia; caudal bupivacaine with or without epinephrine and ilioinguinal-iliohypogastric nerve block are equally effective for postoperative analgesia.
AB - We studied the time to postoperative micturition and the duration of analgesia in 82 children aged 6 mo to 10 yr undergoing herniorrhaphy or orchiopexy under general anesthesia with N2O and halothane. All received D5 lactated Ringer's solution equivalent to 6 h maintenance intraoperatively, and oral fluids postoperatively ad libitum. At the end of surgery, patients were randomly assigned to receive one of three regional anesthetic injections using 0.25% bupivacaine: caudal, 0.75 mL/kg (group I); caudal with 1:200,000 epinephrine, 0.75 mL/kg (group II); or ilioinguinal-iliohypogastric nerve block with epinephrine through the wound by the surgeon (group III). Postoperatively, blinded observers scored pain at 30 min, hourly until discharge, and by telephone at 24-36 h. In the 74 patients with successful blocks (mean age 2.5 ± 2.4 yr), the times to micturition (group I, 202 ± 130 min; group II, 262 ± 164 min; group III, 196 ± 101 min) did not differ significantly among groups. Seven patients who took more than 8 h to void required no intervention. There was no difference in the numbers without pain for ≥4 h (74%, 64%, and 69% of groups I, II, and III), or those requiring analgesics by 24 h (66% overall). The time to postoperative voiding in children is variable and not prolonged by caudal analgesia; caudal bupivacaine with or without epinephrine and ilioinguinal-iliohypogastric nerve block are equally effective for postoperative analgesia.
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U2 - 10.1213/00000539-199301000-00029
DO - 10.1213/00000539-199301000-00029
M3 - Article
C2 - 8418720
AN - SCOPUS:0027477839
SN - 0003-2999
VL - 76
SP - 173
EP - 177
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 1
ER -