Low concentration of caudal bupivacaine for postoperative analgesia in elective pediatric surgery.

This report summarizes [corrected] our experiences in 0.125% bupivacaine caudal analgesia in 70 pediatric patients with age ranging from 3 months to 7 years undergoing routine surgical procedures including herniorrhaphies, orchiopexies, and circumcision. The local anesthetic chosen was 0.125% bupivacaine with epinephrine (1:200,000) being added and the dosage administered [corrected] varied from 0.5-1.0 ml/kg depending upon the sites of the surgical procedures. In the recovery room, patients were observed and accessed using the modified Hannallah's pain/discomfort scoring system. Patients who achieved a score of four or more during a 30 min observation period were given codeine 1 mg/kg intramuscularly and the blocks were rated as uneffective. Our result was that 0.125% bupivacaine caudal analgesia was effective. The rate of success was 79%. The duration of analgesia was 4-8 hours. No delay or difficulty in urination was found. Most of the patients could move their lower extremities but could not bear their weight. Telephone follow-up failed to reveal any analgesia-related complication.