BACKGROUND: We wanted to determine the postoperative analgesic efficacy of preincisional caudal epidural block versus instillation (splash block) following inguinal herniorrhaphy in children. METHODS: Thirty children (age range: 1-7 years) who were scheduled to undergo inguinal herniorrhaphy were divided into 2 groups: the caudal block group and the splash block group with 15 children in each group. Tracheal intubation was performed. Fifteen children received caudal block with 1.0 ml/kg of 0.25% ropivacaine (Group 1). Caudal block was performed using the loss of resistance method via the sacral hiatus. Fifteen children in Group 2 received local instillation (splash block) in the surgical site with up to 0.4 ml/kg of 0.25% ropivacaine. The patients were observed for 90 minutes in the postanesthesia care unit and then they were transferred to the ward. The pain scores were taken 4 times. We assessed pain using the Faces pain scores. RESULTS: There were no significant differences between the groups regarding the pain scores at 10, 30 and 60 minutes upon entering the postanesthesia care unit. The pain scores of Group 1 were slightly lower at the last evaluation point when compared to that of Group 2. One patient in Group 1 required supplemental postoperative intravenous (IV) tramadol, while all the other patients in both groups did not require supplemental IV tramadol. The intraoperative requirement for sevoflurane was decreased in Group 1 as compared to that of Group 2. There were no major complications related to either type of block. CONCLUSIONS: We conclude that a splash block can have a similar analgesic effect as that of a caudal block for the postoperative herniorrhaphy pain of children.
Amides ; Analgesia ; Child ; Herniorrhaphy ; Humans ; Intubation ; Methyl Ethers ; Tramadol

We report a case of intussusception of the cecum and appendix arising in pericecal endometriosis that are mistaken as a cecal tumor preoperatively. At the other OBGY clinic, the 1st lapalotomy was performed for management of leiomyoma but pelvic organs were adhesion severely and palpation mass in the cecum and appendix. The patient was transfer to our hospital for evaluation and treatment of mass. We investigated to intestine closely and diagnosis was cecal tumor colonoscopically. Total hystrectomy and iliocecectomy was performed successfully and discovered intussusception of the cecum and appendix due to endometriosis mistaken as a cecal tumor in operative field. Postoperatively, this case was diagnosed in pericecal endometriosis histologically.
Appendix* ; Cecum* ; Diagnosis ; Endometriosis* ; Female ; Humans ; Intestines ; Intussusception* ; Leiomyoma ; Palpation