Fifty children aged 6 months to 6 years were included in the study. Children were divided blindly between the two groups to receive pre- vs. post-incisional caudal
bupivacaine. The preincisional group received 1 ml/kg of 0.125%
bupivacaine caudally after induction of
anesthesia and the postincisional group received the same dose caudally at the end of surgery. Heart rate, SaO(2), end tidal CO(2), and noninvasive arterial blood pressure were recorded every 10 min. The duration of surgery, extubation time, and duration of recovery period were also recorded. The
pain scores were measured with using an Oucher chart in the recovery room, 2, 4, 6, 12, and 24 h after surgery. Time to first
analgesia, numbers of supplementary
analgesics required by each child in a 24-h period and total
analgesic consumptions were recorded. Any local and systemic complications were recorded. Quantitative data were compared using a two-tailed t-test. Sex distribution and frequency of
acetaminophen consumption were measured using χ(2) test. P < 0.05 was considered statistically significant.
RESULTS: The Oucher
pain scale at 4, 6, 12, and 24 h after surgery, the total
analgesic consumption and the numbers of demand for supplemental
acetaminophen were lower statistically in preincisional group (P < 0.05). Extubation time and duration were higher in preincisional group (P < 0.05). Mean changes of heart rates were statistically lower during the
anesthesia period and recovery time in preincisional group (P < 0.05).
CONCLUSION: