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Caudal block with analgosedation - a superior anaesthesia technique for lower abdominal surgery in paediatric

Adisa Šabanović Adilović1, Nermina Rizvanović1, Harun Adilović2

  • 1Department of Anaesthesiology and Intensive Care Unit, Cantonal Hospital Zenica, Bosnia and Herzegovina.

Medicinski Glasnik : Official Publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
|June 13, 2019
PubMed

Insights

Caudal block with analgosedation offers superior hemodynamic stability and reduced postoperative pain and delirium in children undergoing lower abdominal surgery compared to general endotracheal anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Surgical Pain Management
  • Regional Anesthesia Techniques

Background:

  • Optimizing anesthesia regimens in pediatric surgery is crucial for patient outcomes.
  • Comparing caudal block with intravenous analgosedation against general endotracheal anesthesia is essential for informed clinical practice.

Purpose of the Study:

  • To compare intraoperative hemodynamic and respiratory stability between caudal block with analgosedation (CB) and general endotracheal anesthesia (GA) in children.
  • To evaluate postoperative emergence delirium and pain intensity in children receiving either CB or GA.
  • To assess the quality of postoperative analgesia in both anesthesia groups.

Main Methods:

  • Forty children aged 2-6 years undergoing lower abdominal surgery were randomized into two groups: CB and GA.
  • Intraoperative hemodynamic (SBP, DBP, MAP, HR) and respiratory (SaO2) stability were monitored at defined time points.
  • Postoperative emergence delirium (PAED score) and pain (CHIPPS score) were assessed at regular intervals.

Main Results:

  • The CB group demonstrated significantly lower systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), and heart rate (HR) intraoperatively.
  • While SaO2 was lower in the CB group, it remained comparable to the GA group.
  • Postoperative Paediatric Anaesthesia Emergence Delirium (PAED) and Children's and Infants' Postoperative Pain (CHIPPS) scores were significantly lower in the CB group.

Conclusions:

  • Caudal block with analgosedation provides superior intraoperative hemodynamic control in pediatric patients.
  • This anesthesia technique effectively reduces postoperative emergence delirium and pain intensity compared to general endotracheal anesthesia.
  • Caudal block with analgosedation is a favorable option for managing anesthesia and analgesia in children undergoing lower abdominal surgery.

Keywords:
analgesiachildren, hemodynamicemergence deliriumpostoperative pain

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