Turkish Journal of Urology
PEDIATRIC UROLOGY - Original Article

Comparison of bupivacaine alone and in a combination with lidocaine for caudal block in patients undergoing circumcision: A historical cohort study

1.

Clinic of Anesthesia, Ayancık State Hospital, Sinop, Turkey

2.

Department of Anesthesia, Gazi University School of Medicine, Ankara, Turkey

3.

Clinic of Anesthesia, Dr. Fazıl Doğan State Hospital, Kütahya, Turkey

4.

Department of Biostatistics, Atatürk University School of Medicine, Erzurum, Turkey

5.

Department of Anesthesia, İstanbul University İstanbul School of Medicine, İstanbul, Turkey

Turk J Urol 2020; 46: 243-248
DOI: 10.5152/tud.2019.19191
Read: 247 Downloads: 96 Published: 03 December 2019

Objective: Optimal analgesia following ambulatory surgery is an important matter in patient satisfaction, and it reduces unnecessary hospital admissions. This study investigated whether a caudal block with bupivacaine alone or in a combination with lidocaine can alter postoperative pain scores, complications, and peroperative and postoperative analgesic consumption.

Material and methods: This is a retrospective study that included children who underwent elective circumcision surgery under general anesthesia and caudal analgesia between January and June 2018. Among the 103 children, 17 cases were not analyzed due to an unsuccessful caudal block and procedures simultaneously underwent another operation unrelated to circumcision. We divided the study participants into two groups according to the type of local anesthetic applied: 0.5 mL/kg 0.25% bupivacaine (Group B) and 0.5 mL/kg 0.25% bupivacaine + 3 mg/kg 1% lidocaine (Group BL) caudally.

Results: Pain scores were similar between these groups and remained in the mild-to-moderate range throughout the hospitalization (p>0.05). There were significant differences regarding the rescue analgesic use, first micturition, and mobilization times (p<0.001). In addition, we applied the multivariable logistic regression for fentanyl consumption adjusted for first mobilization and micturition time, unlike mobilization, a significantly increased risk for postoperative delayed micturition (OR, 1.06; 95% CI, 1.0–1.12; p=0.038) was found with intra-operative intravenous fentanyl use.

Conclusion: Our results suggest that the caudal block with a lidocaine+bupivacaine combination decreases rescue analgesic consumption at day–case surgery. In circumcision procedures, the caudal block is an effective and safe analgesic method for intraoperative and postoperative pain control with no side effects. This trial was registered at Clinicaltrals.gov, NCT03911648.

Cite this article as: Atasever AG, Ermiş O, Şencan Demir B, Kaşali K, Savran Karadeniz M. Comparison of bupivacaine alone and in a combination with lidocaine for caudal block in patients undergoing circumcision: A historical cohort study. Turk J Urol 2020; 46(3): 243-8.

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ISSN2149-3235 EISSN 2149-3057