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Effect of caudal block using different volumes of local anaesthetic on optic nerve sheath diameter in children: a prospective, randomized trial

Authors
 B. Lee  ;  B.-N. Koo  ;  Y. S. Choi  ;  H. K. Kil  ;  M.-S. Kim  ;  J. H. Lee 
Citation
 British Journal of Anaesthesia, Vol.118(5) : 781-787, 2017 
Journal Title
 British Journal of Anaesthesia 
ISSN
 0007-0912 
Issue Date
2017
Keywords
anaesthesia ; caudal ; intracranial hypertension ; optic nerve ; paediatrics ; ultrasonography
Abstract
BACKGROUND: Caudal block is commonly administered for postoperative analgesia in children. Although caudal block with 1.5 ml kg -1 local anaesthetic has been reported to reduce cerebral oxygenation in infants, the effect of caudal block on intracranial pressure (ICP) in children has not been well investigated. Optic nerve sheath diameter (ONSD) correlates with degree of ICP. This study aimed to estimate the effects of caudal block on ICP according to volume of local anaesthetic using ultrasonographic measurement of ONSD in children. METHODS: Eighty patients, 6- to 48-months-old, were randomly allocated to the high-volume (HV) or low-volume (LV) groups for caudal block with ropivacaine 0.15%, 1.5 ml kg -1 or 1.0 ml kg -1 , respectively. Measurement of ONSD was performed before (T0), immediately after (T1), and 10 min (T2) and 30 min (T3) after caudal block. RESULTS: The two groups exhibited significant differences in ONSD according to time ( P Group x Time =0.003). The HV group exhibited significantly greater changes in ONSD from T0 to T2 and T3 than the LV group. However, in both groups, ONSDs at T1, T2 and T3 were significantly greater compared with those at T0, with the highest values at T2. CONCLUSIONS: Caudal block with a high volume of local anaesthetic can cause a greater increase in ICP than caudal block with a low volume of local anaesthetic. However, caudal block with 1.0 ml kg -1 of local anaesthetic can also result in a significant increase in ICP.
Full Text
https://academic.oup.com/bja/article-lookup/doi/10.1093/bja/aex078
DOI
10.1093/bja/aex078
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
구본녀(Koo, Bon-Nyeo) ORCID logo https://orcid.org/0000-0002-3189-1673
길혜금(Kil, Hae Keum)
김민수(Kim, Min Soo) ORCID logo https://orcid.org/0000-0001-8760-4568
이보라(Lee, Bo Ra) ORCID logo https://orcid.org/0000-0002-7699-967X
이재훈(Lee, Jae Hoon) ORCID logo https://orcid.org/0000-0001-6679-2782
최용선(Choi, Yong Seon) ORCID logo https://orcid.org/0000-0002-5348-864X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154413
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