COMPARISON OF CAUDAL BLOCK USING BUPIVACAINE AND KETAMINE WITH ILIOINGUINAL NERVE BLOCK FOR ORCHIDOPEXY IN CHILDREN

Forty boys weighing less than 25 kg undergoing unilateral orchidopexy were randomly allocated to receive one of two analgesic regimens. Grou p C received a caudal epidural block with 0.25% bupivacaine 1 ml.kg(-1 ) and preservative-free ketamine 0.5 mg.kg(-1); Group L received art i lioinguinal nerve block with 0.25%;, bupivacaine 0.5 ml.kg(-1) and inf iltration of the wound with 0.25% bupivacaine 0.5 ml.kg(-1). All subje cts received diclofenac sodium 1-2 mg.kg(-1) as a rectal suppository. Postoperative pain was assessed by means of a modified Objective Pain Score and analgesia was administered if this exceeded a value of 4. Th e median duration of analgesia was 10 h (range 2.6 to >24 h) in Group C and 2.9 h (range 0.7 to >24 h) in Group L (p < 0.05), There were no differences between groups in the incidence of motor block, urinary re tention, postoperative vomiting or postoperative sedation. Subjects in Group L, required significantly more doses of postoperative analgesia than those in Group C (p < 0.05).