A comparison of two concentrations of bupivacaine and adrenaline with and without fentanyl in paediatric inguinal herniorrhaphy

This study was designed to determine whether administration of caudal bupiv acaine with fentanyl would have any effect on analgesia in paediatric patie nts undergoing inguinal hemiorrhaphy repair. Fifty-six outpatient paediatri c patients undergoing inguinal hernia repair were evaluated. Patients recei ved, in a randomized manner, 1 ml.kg(-1) of either bupivacaine 0.25% or 0.1 25% with or without fentanyl 1 mu g.kg(-1). There was no difference in pain scores in the hospital, the night of surgery, or 24 h postoperatively nor was there a difference in the oral analgesics administered between any of t he groups. There was a higher incidence of vomiting at home in both 0.25% b upivacaine groups irrespective of the use of fentanyl. The 0.125% bupivacai ne group had significantly more patients who received intravenous fentanyl in the PACU than did the other three groups (P<0.001). Increasing the conce ntration of bupivacaine from 0.125% to 0.25% increased the incidence of pos toperative vomiting. We recommend that clinicians utilize bupivacaine 0.125 % with 1 mu g.kg(-1) fentanyl as the caudal injectate in paediatric patient s undergiong inguinal hernia repair.