Analgesic Effectiveness between Preemptive Intravenous Acetaminophen and
Single-Shot Caudal Block in Paediatric Inguinal Hernia Repair
Abstract
In an era where fast-track surgery is preferred and more cases are
performed under day care surgery, anaesthesia techniques and pain
management evolve to suit the demand.In our study, we compared the anal-
gesic effectiveness between preemptive intravenous acetaminophen and
single-shot caudal block in paediatric patients undergoing inguinal
hernia repair.
This is a prospective randomised study involving a total
of 40 American Society of Anesthesiologists (ASA) 1 and 2 patients who
are 6 months to 5 years old, randomised into two groups: group A
(intravenous aceta- minophen) and group B (single-shot caudal). Our
primary outcome is the postoperative pain score using Face, Legs,
Activity, Cry, and Consolability (FLACC) scale at several intervals (10
min, 30 min, 1 h, 2 h, and 6 h). The time of first rescue analgesic
requirement was compared. The pain score of group B patients was lower
during the first 1 h postoperatively (p = 0.018) at 10 min, (p = 0.013)
30 min, and (p = 0.05) 1 h and was found to be insignificant beyond the
period. Nonetheless, the mean pain score in both groups was low with
0.15; lowest and 0.45; highest. We found no significant mean time
difference for the first analgesic requirement and mean total opioid
consumption between the two groups. Preemptive IV acetaminophen is
equivocal to caudal block for a paediatric herniotomy surgery. In fact,
IV acetaminophen could give more pharmacoeconomics advantages as it is
easily administered, less time needed hence more rapid turnovers between
the cases and high safety profile