Adequacy of caudal analgesia in children after penoscrotal and inguinal surgery using 0.5 or 1.0 ml.kg-1 bupivacaine 0.125%.

To determine the optimal volume of bupivacaine 0.125% for postoperative caudal analgesia, we compared the effectiveness of 0.5 ml.kg-1 and 1 ml.kg-1 of bupivacaine 0.125% with 1:200,000 epinephrine in 80 children undergoing penoscrotal and inguinal surgery. The adequacy of caudal analgesia and supplemental analgesic requirements did not differ between the two groups at any time during the first 12 hr after surgery. We conclude that 0.5 ml.kg-1 of bupivacaine 0.125% with 1:200,000 epinephrine is as effective as 1 ml.kg-1 of the same solution and recommend its use for penoscrotal surgery. The evidence for effectiveness of 0.5 ml.kg-1 of bupivacaine 0.125% for inguinal surgery, however, is inconclusive because of an insufficient number of patients studied.