Comparing the Effects of Caudal Block and Infiltration of Local Anesthetic on Postoperative Pain Control in Children

Acute postoperative pain in children increases by activation of physiological and biochemical stressresponses and leads to several complications. Caudal block and infiltration of local anesthetic are two effective modalities for postoperative pain management in children. The aim of this study was to compare the effects of these two methods on postoperative pain control in children. In this double blind clinical trial, 110 children who underwent herniorhaphy and orchidopexy, were allocated to two groups of caudal block and wound infiltration using randomized fixed quadripartite blocks.The drug dosage in caudal block group was 1mg/kg of bupivacaine 0.125 % and it was 0.5mg/kg of bupivacaine 0.25% in wound infiltration group. Pain score , time to start of micturition and gas passing, parents’ satisfaction, time for the first dose of acetaminophen , number and total acetaminophen dosage in 24 hours, were noted at 1-6- 12 -24 hours after operation. Pain score significantly diminished in caudal (0.0001) and infiltration (<0.0001) groups. There was no significant difference between the two groups in terms of pain score changes(0.8),time for the first dose of acetaminophen (p=0.77) , number of need for analgesia (p=0.81), total analgesic doses(p=0.9), the onset of intestinal activity(p=0.44) and micturation (p=0.66) during 24 hours after surgery. However, parents’ satisfaction was significantly more in infiltration group (p=0.002) It seems that both methods are effective for this purpose. However, considering the less time needed for the procedure, and more satisfaction of wound infiltration, it might be suggested as the preferred method.