Comparison of Midazolam with Lidocaine and Fentanyl for Caudal Analgesia in Children

To compare postoperative analgesia provided by caudal administration of midazolam and mixture of lidocaine and fentanyl in children, in a randomized, double-blind study, forty children, undergoing hypospadia repair were allocated randomly into two groups (n = 20 in each) to receive a caudal injection of either lidoacaine 4 mg kg-1 added with fentanyl 1 μg kg-1 and epinephrine 1/200000 or midazolam 50 μg kg-1, each solution diluted with normal saline for reaching a volume of 1 mL kg-1. There were no differences in quality of pain relief, postoperative behaviour or analgesic requirements between the midazolam group and the lidoacaine group. Times to first analgesic administration (paracetamol suppositories) were similar in two groups. Caudal midazolam in a dose of 50 μg kg-1 and in a volume of 1 mL kg-1 provides equivalent analgesia to 4 mg kg-1 lidoacaine added to fentanyl and epinephrine, when administered postoperatively for children following hypospadia repair.