Abstract:
UNLABELLED:In this study, we examined the effectiveness of caudal blocks and correlated it with the laxity of the patients' anal sphincter before emergence from anesthesia in 178 children undergoing inguinal and/or penile surgery. Bupivacaine 0.25% in a volume of 0.6-1.25 mL/kg was used in all patients. The presence of a lax anal sphincter at the end of surgery correlated significantly with the reduced administration of narcotics intraoperatively and in the postanesthesia care unit (P < 0.001). The sensitivity of the sphincter tone test was 98.1% with a 95% confidence interval (CI) ranging from 94.3% to 99.6%. The specificity of the test was 94.4% with a 95% CI of 72.0%-100%. The positive predictive value of this test in predicting adequate caudal block was excellent (99.4%) with a 95% CI of 96.1%-100%. The negative predictive value was better than average (85%) with a 95% CI of 62.9%-95.4%. We conclude that a lax anal sphincter can predict the effectiveness of analgesia after pediatric caudal blockade. A tight sphincter may suggest the need to repeat the block before the child awakens, or consider alternate methods of postoperative analgesia. IMPLICATIONS:A lax anal sphincter in children undergoing inguinal and/or penile surgery can predict the effectiveness of analgesia after pediatric caudal blockade.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Verghese ST,Mostello LA,Patel RI,Kaplan RF,Patel KMdoi
10.1097/00000539-200205000-00019subject
Has Abstractpub_date
2002-05-01 00:00:00pages
1161-4, table of contentsissue
5eissn
0003-2999issn
1526-7598journal_volume
94pub_type
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