الفهرس 
Anatomy of Caudal CanalOnly 14 pages are availabe for public view
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Abstract
Background: Pain is one of the most misunderstood, underdiagnosed, and untreated medical problems, particularly in children.Postoperative pain can result in an uncooperative and restless child. Hence, it is preferable to prevent the onset of pain rather than to relieve its existence.
Purpose: To evaluate the effect of adding Morphine to bupivacaine versus bupivacaine alone in caudal analgesia for management of post operative pain in children undergoing hernia repair regarding density of the block, duration of analgesia and occurrence of complication.
Patients and Methods: This is a prospective randomized controlled Trial performed in The operating theatres of Ain Shams University Hospitals, Cairo, Egypt for 6 months over 50 child undergoing hernia repair under general aneesthesia. All Patients were assigned randomly by computer into two equal groups ( each one 25 patients ).First group (group B)Caudal analgesia were done by injection of 1ml/kg of 0.25%bupivacaine .Second group (group BM)Caudal analgesia were done by injection of 1ml/kg of 0.25%bupivacaine and 10 mic.gm/kg morphine .
Results: Our data showed that caudal anesthesia supplemented with low dose of morphine was beneficial in the postoperative pain control compared with patients who received a caudal block with bupivacaine alone. The patients of caudal morphine group required significantly less rescue analgesia(median&range 1&(0-1) ) compared to group of caudal bupivacaine alone(median&range 2&(2-3)).Time of the first dose of post operative analgesia in the caudal morphine group was 12-18 hr.post operatively compared to 6-12 hr.in the other group.
Conclusion: Addition of 10μg/kg morphine to caudal bupivacaine improves post-operative analgesic effect without serious side effects and minimal additional analgesics.