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Korean Journal of Anesthesiology 1993;26(2):326-332.
DOI: https://doi.org/10.4097/kjae.1993.26.2.326   
Optimum Concentration of Lidocaine in Pediatric Caudal Anesthesia for Inguinal Herniorraphy.
Ki Young Lee, Yang Sik Shin, Young Ran Kwak, Yong Taek Nam, Jong Rae Kim, Myo Kyung Lee, Eui Ho Hwang
1Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Pediatric Surgery, Yonsei University College of Medicine, Seoul, Korea.
To determine the best concentration of lidocaine for caudal anesthesia under supplementary general inhalation anesthesia via faee mask, 85 children aged 1 month to 12 years scheduled for inpatients or outpatients inguinal herniorraphy were randomiaed to receive caudal anesthesia with lidocaine in one of four concentrations(0.5, 0.75, 1.0 or 1.5%) mixing l: 200,000 epinephrine. After incision, gradual reduction in inspired halothane resulted, if tolerated by subject, in an inspired concentration of 0.5% at 10 minutes after incision. Percents of patients who received more than 0.5% of endtidal halothane concentration at hernia sac ligation were 30.0, 28.6, 16.7 and 20.0% in the subjeets receiving 0.5, 0.75, 1.0 and 1.5% lidocaine, respectively. There was no significant differences among groups in pain/discomfort scores and caudal effectiveness scores. A subject receiving 1.5 % lidocaine complained of leg weakness and another of retching. About ninety percents of all subjects could gain the analgesic levels at T dermatome although most of subjects receiving 0.5% lidocaine had the short duration less than 1 hour. Postoperative analgesic effects in the subjects receiving 1.0% lidocaine were superior to those receiving 0.5 and 0.75% solution. Although all concentrations were effective for combined general-caudal anesthesia in children, we conclude that 1.0% lidocaine offers the best combination of effectiveness, postoperative analgesia, adequate anesthetic levels and less complication for pediatric inguinal herniorraphy.
Key Words: Pediatric; Herniorraphy; Caudal; Lidocaine


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