The efficacy of a single caudal epidural injection of bupivacaine 20 ml 0.5% following emergency orthopaedic surgery to the lower leg and ankle was investigated. Forty adult patients were studied, randomised to either the caudal or control group. The mean 24 hour postoperative papaveretum consumption was significantly reduced in the caudal group. Analogue pain scores as assessed in a double-blind manner were also significantly reduced in this group. The duration of analgesia after caudal blockade was approximately eight hours as estimated by the average time to the first dose of papaveretum. Our study demonstrates that caudal blockade represents an effective adjunct to intramuscular opiates following this type of surgery.
FreundP.R., BowdleT.A., SlatteryJ.T., BellL.E.Caudal anaesthesia with lidocaine or bupivacaine: Plasma local anaesthetic concentration and extent of sensory spread in old and young patients. Anesth Analg1984; 63: 1017–1020.
8.
ParkW.Y., MassengaleM., MacNamaraT.E.Age, height and speed of injection as factors determining caudal anaesthetic level and occurrence of severe hypertension. Anesthesiology1979; 51: 81–84.
9.
WillisR.J.Caudal Epidural Blockade. In: CousinsM.J., BridenbaughP.O.Neural Blockade in clinical anaesthesia and management of pain. 2nd ed. JP Lippincott Company1980; 361–387.
10.
PrynS.J., CrosseM.M., MurisonM.S.C., McGinnF.P.Postoperative analgesia for haemorrhoidectomy. A comparison between caudal and local infiltration. Anaesthesia1989; 44: 964–6.
11.
BaileyP.M., SangwanS.Caudal analgesia for perianal surgery: A comparison between bupivacaine and diamorphine. Anaesthesia1986; 41: 499–504.
