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Presurgical caudal block attenuates stress response in children
Samia N Khalil1, Ehab Hanna, Adel Farag
1University of Texas Medical School at Houston, USA. Samia.N.Khalil@uth.tmc.edu
Insights
Presurgical caudal block anesthesia reduces the stress response in children undergoing minor surgery, leading to less pain medication and shorter recovery times compared to other methods.
Area of Science:
- Pediatric Anesthesiology
- Surgical Stress Response
- Pain Management
Background:
- The stress response in children after minor surgery can be indicated by elevated blood glucose levels.
- Perioperative glucose administration can influence stress markers in pediatric patients.
Purpose of the Study:
- To investigate the impact of different anesthesia techniques on the pediatric stress response post-surgery.
- To compare the effectiveness of presurgical caudal block, intravenous narcotics, and postsurgical caudal block for pain relief.
Main Methods:
- Twenty-eight children (17-81 months) undergoing elective urologic procedures were divided into three groups.
- Group 1 received presurgical caudal block, Group 2 received intravenous narcotics, and Group 3 received postsurgical caudal block for pain relief.
- Blood glucose levels were measured at baseline, during surgery, and post-surgery to assess stress response.
Main Results:
- Presurgical caudal block (Group 1) showed no significant change in glucose levels, indicating an attenuated stress response.
- Postsurgical caudal block (Group 3) and intravenous narcotics (Group 2) resulted in significant increases in blood glucose levels.
- Children receiving presurgical caudal block required less postoperative narcotic medication and had shorter recovery times.
Conclusions:
- Presurgical caudal analgesia effectively attenuates the stress response to anesthesia and surgery in children.
- This technique also reduces the need for postoperative narcotic use.
- Intravenous narcotics were associated with prolonged postanesthesia care unit (PACU) and hospital stays.
Background:
Our aim was to determine if the anesthesia technique for pain relief in children affects the stress response after minor surgery. A rise in blood glucose reflects stress-related effects in children who do not receive glucose perioperatively.
Methods:
Twenty-eight children, ages 17-81 mos, undergoing elective urologic procedures, were enrolled. For pain relief, patients received presurgical caudal block (group 1), intravenous narcotics (group 2), or postsurgical caudal block (group 3). Blood samples were analyzed for glucose concentrations immediately after induction of anesthesia at baseline, 15 min after surgical incision (second sample), and 30 min after end of surgery (third sample).
Results:
In group 1 there was no change in glucose concentration in the second or third samples compared to baseline, while in group 3 there were significant increases in those samples, and in group 2 there was a significant increase in the second sample compared to baseline. Children in group 1 required significantly fewer narcotics in the postanesthesia care unit (PACU), and those in group 2 had significantly longer PACU and hospital durations.
Conclusions:
Presurgical caudal analgesia attenuates the stress response of anesthesia and surgery and decreases postoperative narcotic use while narcotics prolong PACU and discharge times.
