[Pediatric anesthesia and stress response]

Area of Science:

• Pediatric Anesthesiology
• Surgical Stress Response
• Pain Management

Background:

• Surgical procedures trigger significant hyperglycemic and adrenocortical responses in children.
• Understanding and mitigating these stress responses is crucial for pediatric surgical care.

Purpose of the Study:

• To investigate the impact of different anesthetic techniques on endocrine-metabolic responses to abdominal surgery in children.
• To evaluate the efficacy of intravenous fentanyl and epidural anesthesia in blunting surgical stress.

Main Methods:

• Four groups of children undergoing abdominal surgery were studied.
• Group F: Light general anesthesia with intravenous fentanyl.
• Groups L-E and T-E: Light general anesthesia with lumbar or thoracic epidural anesthesia (lidocaine).
• Group H: General anesthesia (halothane).

Main Results:

• Intravenous fentanyl (10-13 µg/kg) significantly inhibited hyperglycemic and adrenocortical responses.
• Lumbar and thoracic epidural anesthesia with lidocaine did not inhibit these stress responses.
• General anesthesia alone did not inhibit the responses.

Conclusions:

• Intravenous fentanyl is effective in preventing endocrine-metabolic stress responses during pediatric abdominal surgery.
• The concentration and volume of lidocaine may influence the effectiveness of epidural anesthesia.
• Combined general and epidural anesthesia offers excellent postoperative pain management.