A double-blind controlled trial was performed to assess the effectiveness of wound infiltration with bupivacaine for postoperative pain relief after appendicectomy in children. Sixty children entered the trial and 52 completed it; they were randomized to receive bupivacaine or placebo. Assessment of postoperative pain using a numerical scoring system was made by the child, the recovery sister and the ward sister, and by measurement of the time between the end of the operation and the need for narcotic injection. Analysis revealed significantly less pain (P < 0.03) in the immediate postoperative period in the treated group. The use of bupivacaine wound infiltration as a supplement to other current methods of pain control is recommended.

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The fortunate foreskin of an infant boy will usually be left well alone by everyone but its owner. Problems such as phimosis are not common, and can usually be treated medically without resort to circumcision.