BackgroundWe wanted to determine the postoperative analgesic efficacy of preincisional caudal epidural block versus instillation (splash block) following inguinal herniorrhaphy in children.MethodsThirty children (age range: 1-7 years) who were scheduled to undergo inguinal herniorrhaphy were divided into 2 groups: the caudal block group and the splash block group with 15 children in each group. Tracheal intubation was performed. Fifteen children received caudal block with 1.0 ml/kg of 0.25% ropivacaine (Group 1). Caudal block was performed using the loss of resistance method via the sacral hiatus. Fifteen children in Group 2 received local instillation (splash block) in the surgical site with up to 0.4 ml/kg of 0.25% ropivacaine. The patients were observed for 90 minutes in the postanesthesia care unit and then they were transferred to the ward. The pain scores were taken 4 times. We assessed pain using the Faces pain scores.ResultsThere were no significant differences between the groups regarding the pain scores at 10, 30 and 60 minutes upon entering the postanesthesia care unit. The pain scores of Group 1 were slightly lower at the last evaluation point when compared to that of Group 2. One patient in Group 1 required supplemental postoperative intravenous (IV) tramadol, while all the other patients in both groups did not require supplemental IV tramadol. The intraoperative requirement for sevoflurane was decreased in Group 1 as compared to that of Group 2. There were no major complications related to either type of block.ConclusionsWe conclude that a splash block can have a similar analgesic effect as that of a caudal block for the postoperative herniorrhaphy pain of children.

Non-puerperal uterine inversion is a rare clinical problem with only 150 cases reported. It usually results from a tumor implanted on fundus of the uterus. Uterine inversion associated with pelvic organ prolapse (POP) is extremely rare with only 1 case reported. A 74-year-old multiparous menopausal women was admitted to our hospital with the following condition: purulent vaginal discharge, voiding diffi culty, lower abdominal discomfort, vaginal bleeding, protruding vaginal mass and POP. She was diagnosed as a POP with uterine inversion. After a posterior hysterotomy, vaginal hysterectomy, bilateral salpingoophorectomy and colpocleisis was performed and the pathological examination revealed a pyometra. We report a rare case of uterine inversion associated with POP and pyometra with a brief review of literature.