Comparison Between Caudal and Combined Caudal with Spinal Anesthesia in Paediatric Bilateral Inguinal Hernia Surgery

Authors

  • Syed Rafat Ali Hashmi Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Syed Qasim Ali Shah Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Waqas Tariq Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Ahmed Sarfaraz Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Hafiz Ahmed Hassam bhalli Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Taimur Azam Khan Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i6.10168

Keywords:

Analgesia, Bilateral inguinal hernia, Caudal anaesthesia, Caudal combined with spinal anaesthesia

Abstract

Objective: To compare the analgesic efficacy and adverse effect profile of using caudal anaesthesia versus caudal combined with spinal anaesthesia for paediatric patients undergoing bilateral inguinal hernia surgery.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Anaesthesia Department of Combined Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2022.

Methodology: Eighty paediatric patients between ages 5-10 years requiring bilateral inguinal hernia repair were included in the study. The Caudal Group received 0.25% Bupivacaine per the Armitage regime at a 1 ml/kg volume to reach an effective sensory level of T10. The Combined Group received spinal anaesthesia at a dose of 0.3 mg/kg for >15 kg patients and 0.4 mg/kg for 5-15 kg patients in the L4-L5 epidural space for an effective spinal level of T10. Once the spinal was administered, the same caudal dose as per the caudal Group's Armitage regime.

Results: The total duration of block and subsequent reversal to the S1 level was 326.2±12.6 minutes in the Caudal Group
versus 441.22±31.8 minutes in the Combined Group (p<0.001). The mean time for the first dose of analgesia for pain was
required after 5.27±0.24 hours in the caudal versus 7.03±0.20 hours in the Combined Group.

Conclusion: We conclude that the combined caudal spinal approach offers better and superior pain control, resulting in less IV analgesic requirement and less hospital stay, offering a good alternative to general anaesthesia in paediatric surgeries.

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Published

29-12-2023

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Original Articles

How to Cite

1.
Ali Hashmi SR, Ali Shah SQ, Tariq W, Sarfaraz A, Hassam bhalli HA, Khan TA. Comparison Between Caudal and Combined Caudal with Spinal Anesthesia in Paediatric Bilateral Inguinal Hernia Surgery. Pak Armed Forces Med J [Internet]. 2023 Dec. 29 [cited 2024 Jul. 3];73(6):1786-9. Available from: https://pafmj.org/PAFMJ/article/view/10168