Evaluation of adding preoperative or postoperative rectal paracetamol to caudal bupivacaine for postoperative analgesia in children.

Background: Our aim was to investigate whether effects of caudal analgesia could be extended by preoperative or postoperative rectal paracetamol administration in children undergoing surgical repair of hypospadias.

Methods: The group consisted of 60 ASA I boys, aged 3-12 years, who were operated for surgical repair of hypospadias. The patients were randomized into three groups: patients in group I received rectal paracetamol (20-25 mg x kg(-1)) just before the operation. Group II received only caudal bupivacaine. Group III patients received rectal paracetamol (20-25 mg x kg(-1)) at the end of the operation. Pain was assessed by Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and the degree of sedation was evaluated. During the first 24 h, time to the patients' first analgesic requirement and the number of supplementary analgesics needed were recorded.

Results: There was no difference between the demographic and haemodynamic data of the three groups. In addition, the duration of surgery and anaesthesia, pain scores and sedation scores of the groups were not significantly different.

Conclusions: Addition of preoperative or postoperative rectal paracetamol in the doses used did not show an effect on the duration and intensity of postoperative analgesia obtained by caudal bupivacaine.