Author/Editor		Vintar, N
Title		Kombinacija križnične epiduralne in splošne anestezije za ambulantno obrezovanje dečkov: trajanje analgezije pri dveh različnih odmerkih bupivakaina
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1994
Volume		str. 44
Language		slo
Abstract		Caudal anesthesia combined with light general anesthesia is a safe childrens' anesthetic method and enables an excellent and longlasting postoperative analgesia. Recommended dosage of local anesthetic injected in caudal epidural space for urologic operations on penis vary widely among different authors. We decided to find the lowest caudally injected effective dose of local anesthetic which would still provide effective longlasting postoperative analgesia and enable quick and safe recovery after outpatient circumcision of boys. The study was performed at the Urological outpatient clinic in Ljubljana. It included two groups of 31 healthy boys in the age between 2 and 6 years. They all received oral premedication of midazolam (0.4mg/kg body weight (BW)). Induction and maintenance of anesthesia was achieved by inhalation of anesthetic gas mixture (02/N202/halothane). After falling asleep boys received intravenous catheters and then caudal epidural blocks in left lateral position. To group A 0.5ml/kg BW of 0.15 per cent of bupivacaine was injected caudally, to group B 0.33ml/kg BW of 0.125 per cent bupivacaine. The data in the postoperative period were obtained out of questionnaires given to parents after operation and were statistically analyzed by chi-square test and Student's t test. Boys of both groups woke up calm. After tender loving care of their parents 92 per cent of children were quiet and satisfied. In both groups postoperative analgesia lasted longer than 12 hours in 59 per cent of boys, the calculated shortest duration of analgesia was 7.87 hours for both groups. T he statistical difference among the groups was not significant. In group A 51.6 per cent and in group B 70 per cent of boys needed no analgesic therapy during the first postoperative day. 82 per cent of boys of both groups did not vomit. Muscular weakness, assumed by parents, appeared partially in 20 per cent of boys in both groups. In group A boys urinated on average in 7.(trunc.)
Descriptors		CIRCUMCISION PENIS ANESTHESIA, CAUDAL ANESTHESIA, GENERAL BUPIVACAINE CHILD PREANESTHETIC MEDICATION MIDAZOLAM QUESTIONNAIRES