الفهرس 
Catheters
CAUDAL ADJUVANTSOnly 14 pages are availabe for public view
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Abstract
Pre-emptive analgesia involves the introduction of an analgesic before the onset of noxious stimuli. Prevention of the initial neural cascade could lead to eliminating the hypersensitivity produced by noxious stimuli (1).
One of the techniques for prevention of postoperative pain in children involves the use of a caudal block. Single-shot caudal epidural blockade is one of the most widespread techniques used to provide intra- and postoperative analgesia in pediatric patients, and it is relatively easy to perform (2(.
Caudal block may be performed prior to surgery in combination with general anesthesia, after surgery for postoperative analgesia, or instead of general anesthesia for lower abdominal and lower extremity Procedures (3(.
These benefits are especially important in ambulatory and same-day surgery patients because it reduces analgesic requirements and facilitates early discharge. The ease of placing a caudal block, its safety & reliability in providing good postoperative analgesia are well known (4).
The use of caudal route for providing postoperative analgesia using longer acting local anesthetics or opioid analgesics or a combination of both has become a standard practice in many hospitals, with the advantages of ease of application, reducing the requirement of inhalational anesthetics, and providing effective postoperative analgesia (5).
Bupivacaine is the most commonly used local anesthetic in caudal anaesthesia in pediatric practice, and it provides reliable, long-lasting anesthesia and analgesia when given via the caudal route. However, the mean duration of surgical analgesia provided by local anesthetics is limited and thus single shot caudal anesthesia is indicated only for surgery expected to last less than 90 minute (6).