Br. J. Anaesth. (1982), 54,1263 POSTOPERATIVE ANALGESIA AFTER CIRCUMCISION IN CHILDREN

The analgesic effects of systemically administered diamorphine, caudal analgesia with 0.5 % bupivacaine plain and caudal analgesia with 0.5 % bupivacaine pUin to which morphine sulphate had been added were studied in boys undergoing circumcision. Postoperative analgesia was assessed using a linear analogue scale The time interval between operation and subsequent analgesic administration and the number of analgesic doses in 24 h were compared. The frequency of vomiting was noted. All three methods provided satisfactory results. The only detectable difference between the groups was a more rapid, but transient, recovery in the group receiving plain bupivacaine only. The frequency of vomiting was high in all groups. Caudal analgesia, with or without the addition of morphine, did not confer any advantage over injected diamorphine, and did not justify the extra time, risk and expense required to carry it out. For some years the author has used a technique based on the administration of diamorphine during operation to provide postoperative analgesia after circumcision, with satisfactory results. Caudal analgesia has been recommended (Kay, 1974) and its use was found to provide results which wer