postoperative pain management with caudal blockage versus apotel®administration in pediatrics undergoing inguinal herniorrhaphyunder sevoflurane anaesthesia

aim and background:   postoperative pain is a frequent complication in young children undergoing general anaesthesi. sevoflurane anaesthesia in children has been related with higher incidence of postoperative emergence delirium in comparison with halothane, which some blame the pain as it&aposs; main reason. the current study was designed to compare the effect of caudal block versus apotel adminstraion on postoperative pain in pediatrics undergoing inguinal herniorrhaphy under sevoflurane anaesthesia. methods and materials:   in this clinical trial, 60 children aged 2-8 years who were candidate for elective inguinal herniorrhaphy were included. after maintenance with sevoflurane, the patients were randomly allocated to receive caudal anesthesia or intravenous apotel 15 mg.kg   -1 . after extubation, patient’s pain scores were assessed with children’s hospital of eastern ontario scale (cheops). fentanyl was administered in cases suffered from acute pain with cheops   ≥ 10. findings:   postoperative pain in caudal block group was significantly lower than in apotel group (cheops=7.2 vs 8, p=0.017) and opioid was administered much more in apotel group (p=0.003). conclusions:   caudal block in comparison with apotel is more effective in postoperative pain reduction and is associated with less need for opioids.