Abstract

Background: Pain in children received even less interest than pain in adults and has been an essentially ignored dimension of care. Caudal extradural block is the most popular central neuraxial block in pediatric practice. It is used with general anesthesia for intra operative and post-operative analgesia in patients having procedures involving lower limbs, ano-perineal, genitourinary and abdominal surgery below the umbilicus. Most commonly employed group of drugs in caudal analgesia are local anesthetics and opioids. Other alternative agents to prolong the duration of caudal analgesia are Ketamine, Neostigmine and Midazolam

Materials and Methods: It was a prospective randomized control study in sixty children undergoing elective inguinal herniotomy, orchiopexy and circumcision after obtaining informed consent from parents. Patients were randomly allocated into two groups, of 30 each.

Group I - patients received 0.25% preservative free bupivacaine in the dose of lml/kg, mixed with 50µg/kg of preservative free midazolam

Group II - patients received 0.25% preservative free bupivacaine in a dose of lml/kg.

The duration of post-operative analgesia was assessed

Results: Patients who received midazolam for caudal block has extended post-operative analgesia when compared to those who received bupivacaine alone. The incidence of sedation was not significant in the study group.

Conclusion: The addition of midazolam with bupivacaine for caudal epidural block will prolong the duration of post-operative analgesia.

Keywords: Midazolam, Caudal epidural block, Post-operative analgesia.