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The Effect of Caudal Anesthesia Block on Perioperative Pain Control and Reduction of the Anesthetic Agent in

Zeana Amer Gawe1, Hasan Mohamed Isa2, Muatasem Mohamed Almashaur3

  • 1Department of Anesthesia, Salmaniya Medical Complex, Government Hospital in Bahrain, Manama, Bahrain.

Anesthesia, Essays and Researches
|January 9, 2023
PubMed

Insights

Caudal epidural block (CEB) combined with general anesthesia significantly improves pain management and recovery for pediatric infraumbilical surgery. This approach enhances hemodynamic stability, reduces pain, and increases parental satisfaction.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Caudal epidural block (CEB) is a common neuraxial technique for pediatric pain relief during infraumbilical surgery.
  • Optimizing intraoperative and postoperative pain control is crucial for pediatric surgical patients.

Purpose of the Study:

  • To compare the effectiveness of adding CEB to general anesthesia (GA) for pain management in pediatric patients undergoing infraumbilical surgery.
  • To evaluate the impact of CEB on hemodynamic stability, pain scores, sedation, analgesia requirements, and parental satisfaction.

Main Methods:

  • A prospective, randomized controlled trial involving 74 pediatric patients (2 months to 6 years) classified as ASA I.
  • Patients were divided into two groups: one receiving GA with CEB (Group A) and the other receiving GA alone (Group B).
  • Data collected included hemodynamic parameters, pain scores, sedation levels, analgesic use, and parental satisfaction, analyzed using SPSS.

Main Results:

  • Patients receiving CEB demonstrated improved hemodynamic stability (heart rate, P=0.039) and significantly lower pain intensity scores (P<0.001).
  • CEB group required less intraoperative fentanyl (P=0.002), experienced earlier ambulation, and had shorter hospital stays.
  • Parental satisfaction was notably higher in the CEB group (92.1%) compared to the control group (63.9%, P=0.012).

Conclusions:

  • Adding CEB to GA provides effective and safe intraoperative and perioperative pain control for pediatric infraumbilical surgery.
  • CEB enhances recovery, reduces opioid requirements, and significantly improves parental satisfaction.
  • CEB is a valuable adjunct for optimizing outcomes in pediatric surgical anesthesia.
Abstract

Keywords:
Analgesiccaudal anesthesiageneral anesthesiapain managementpediatricperioperativesedation

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