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[Effects of caudal block in pediatric surgical patients: a randomized clinical trial]

Anna Uram Benka1, Marina Pandurov1, Izabella Fabri Galambos1

  • 1University of Novi Sad, Medical Faculty, Department of Anesthesia and Perioperative Medicine, Novi Sad, República da Sérvia; Institute for the Healthcare of Children and Youth of Vojvodina, Clinic of Pediatric surgery, Department for Pediatric Anesthesia, Intensive Care and Pain Therapy, Novi Sad, República da Sérvia.

Brazilian Journal of Anesthesiology (Elsevier)
|March 25, 2020
PubMed

Insights

Caudal blocks combined with general anesthesia significantly reduce pain and the stress response in pediatric patients undergoing surgery. This approach enhances hemodynamic stability and lowers medication needs without complications.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Surgery triggers a significant neuroendocrine stress response.
  • This response can lead to hemodynamic instability, metabolic changes, and immune system dysfunction.
  • Effective pain and stress management in pediatric surgery is crucial.

Purpose of the Study:

  • To evaluate the efficacy of caudal blocks in managing intraoperative and postoperative pain in children.
  • To assess the impact of caudal blocks on reducing the surgical stress response.
  • To determine the safety and effectiveness of caudal blocks in pediatric herniorrhaphy.

Main Methods:

  • A prospective, randomized clinical trial involving 60 pediatric patients undergoing elective herniorrhaphy.
  • Comparison between general anesthesia alone and general anesthesia combined with caudal block.
  • Monitoring of hemodynamic parameters, pain scores, drug consumption, and serum glucose and cortisol levels.

Main Results:

  • Patients receiving caudal blocks exhibited significantly lower serum glucose and cortisol levels (p < 0.01).
  • Reduced pain scores were observed at 3 and 6 hours post-operation (p = 0.002, p = 0.003).
  • Improved hemodynamic stability, decreased medication requirements, and no reported side effects were noted in the caudal block group.

Conclusions:

  • Combining caudal block with general anesthesia is a safe and effective strategy for pediatric surgery.
  • This combined approach significantly mitigates the stress response, enhances hemodynamic stability, and reduces pain.
  • Caudal blocks lead to lower pain scores and decreased medication consumption in pediatric patients.
Abstract

Keywords:
Anestesia geralBloqueio caudalCaudal blockChildrenCriançasGeneral anesthesiaReposta ao estresseStress response

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