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Caudal epidural analgesia (caudal block)is used in standard pediatric anesthesia practice. It has been shown to be effective in managing postoperative pain in children undergoing abdominal and infraumbilical surgery (Tobias et al 1994). Furthermore, studies have shown that children receiving caudal blocks have secondary benefits such as lower narcotic and anesthetic requirements, more rapid awakening from general anesthesia, decreased time to discharge home, and fewer pain-related behaviors postoperatively (Conroy et al 1993, Tobias et al 1995, Tobias 1996).
This proposed study involves the use of a caudal block in children undergoing elective inguinal herniorrhaphy or orchiopexy to evaluate the role of preemptive analgesia in pediatric pain management. We hypothesize that by inhibiting peripheral pain receptors with a caudal block before the onset of a painful stimulus, we can decrease central nervous system sensitization and reduce postoperative analgesic requirements
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group CB (Caudal Before-study group) | This group will receive caudal ropivacaine and epinephrine after induction of general anesthesia prior to surgical incision | ||
| Caudal After (CA)-control group | This group will receive caudal ropivacaine with epinephrine after completion of surgery but before emergence from anesthesia | ||
| Local Infiltration After (LIA) control group | This group will receive local infiltration of ropivacaine around the surgery site at the conclusion of surgery but before emergence from anesthesia |
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| Measure | Description | Time Frame |
|---|---|---|
| Usage of pain medications | over 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Pain scores | At various intervals for first 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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Children under 2 years of age having an elective inguinal herniorrhaphy or orchiopexy.
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| Name | Affiliation | Role |
|---|---|---|
| Shannon Mulder, MD | Loma Linda University Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Loma Linda University Medical Center | Loma Linda | California | 92354 | United States | ||
| Loma Linda University Outpatient Surgery Center |
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| ID | Term |
|---|---|
| D006552 | Hernia, Inguinal |
| ID | Term |
|---|---|
| D046449 | Hernia, Abdominal |
| D006547 | Hernia |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Loma Linda |
| California |
| 92354 |
| United States |