Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Caudal block for postoperative analgesia in children.
A clinical trial was performed to compare the effects of intramuscular dihydrocodeine with caudal bupivacaine on postoperative pain and recovery in 181 children who had undergone either circumcision, inguinal herniotomy or orchidopexy performed under general anaesthesia. Linear analogues were used in assess level of consciousness and apparent pain. Recovery of consciousness was slower after caudal analgesia. For 90 minutes following circumcision there was significantly less pain and caudal analgesia, but better pain relief could not be demonstrated following inguinal herniotomy and orchidopexy.
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Entrainment of air following exploration of posterior cranial fossa in the sitting position was studied in five patients. Intracranial pressure was monitored through a ventriculostomy catheter after closure of the dura. In three patients nitrous oxide was added to the breathing mixture only after the baseline intracranial pressure had stabilised following closure of the dura. ⋯ Two patients were nitrous oxide from the beginning. No change in intracranial pressure was noted. Computerised tomogram on the first postoperative day revealed a significant amount of air in eight cases.