PRESURGICAL ANALGESIA IN CHILDREN SUBJECTED TO HYPOSPADIAS REPAIR

We have examined the use of different pre-surgical analgesic techniques in 30 children aged 2-1 Oyr undergoing repair of hypospadias. They were allocated randomly, in a double-blind, placebo-controlled study, to receive one of three analgesic techniques (n = 10): lumbar extradural analgesia using 0.5 % bupivacaine 1 mg kg'1 plus morphine 50 ng kg'1; morphine 100 fig kg~ ' i.m.; or subpubic block using 0.5 % bupivacaine 0.5 mg kg' ' for each side. Analgesics were given after induction of anaesthesia and before the start of surgery. Children given extradural analgesia had more stable haemo-dynamic variables and smaller catecholamine con-centrations and needed less anaesthetic supple-mentation, with no analgesic requirement in the postoperative period. Nausea or vomiting were not reported in children given subpubic block. (Br. J