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Effect of caudal block on sevoflurane requirement for lower limb surgery in children with cerebral palsy

Authors
 Soo Hwan Kim  ;  Duk-Hee Chun  ;  Chul Ho Chang  ;  Tae Wan Kim  ;  Young Mi Kim  ;  Yang-Sik Shin 
Citation
 PEDIATRIC ANESTHESIA, Vol.21(4) : 394-398, 2011 
Journal Title
PEDIATRIC ANESTHESIA
ISSN
 1155-5645 
Issue Date
2011
MeSH
Achilles Tendon/surgery ; Anesthesia, Caudal* ; Anesthesia, General ; Anesthesia, Inhalation* ; Anesthetics, Inhalation/administration & dosage* ; Blood Pressure/drug effects ; Cerebral Palsy/complications* ; Child ; Consciousness Monitors ; Double-Blind Method ; Female ; Heart Rate/drug effects ; Humans ; Lower Extremity/surgery* ; Male ; Methyl Ethers/administration & dosage* ; Prospective Studies
Keywords
caudal block ; cerebral palsy ; bispectral index ; sevoflurane
Abstract
BACKGROUND: Caudal block is a widely used technique for providing perioperative pain management in children. In this randomized double-blinded study, we evaluated the effects of preoperative caudal block on sevoflurane requirements in children with cerebral palsy (CP) undergoing lower limb surgery while bispectral index (BIS) values were maintained between 45 and 55.

METHODS: 52 children undergoing Achilles-tendon lengthening were randomized to receive combined general-caudal anesthesia (caudal group, n = 27) or general anesthesia alone (control group, n = 25). Caudal block was performed with a single dose of 0.7 ml·kg(-1) of 1.0% lidocaine containing epinephrine at 5 μg·ml(-1). The control group received no preoperative caudal block. The endtidal sevoflurane concentrations (ET(sev)) were adjusted every minute to maintain the BIS values between 45 and 55.

RESULTS: The ET(sev) required to maintain the BIS values were not significantly different between the control and caudal groups after induction of anesthesia [2.1 (0.2) vs 2.2 (0.4); P = 0.773]. However, significantly higher ET(sev) was observed in the control group before surgical incision [2.0 (0.2) vs 1.8 (0.3); P = 0.013] and during the first 20 min after surgical incision [2.2 (0.3) vs 1.4 (0.3); P < 0.001]. There was no significant difference in BIS values between the control and caudal groups throughout the study period (P > 0.05). In the caudal group, the caudal block was successful in 25 of 27 (92.6%) patients.

CONCLUSIONS: Caudal block effectively reduced sevoflurane requirements by 36% compared to general anesthesia alone in children with CP undergoing lower limb surgery while BIS values were maintained between 45 and 55.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2011.03530.x/abstract
DOI
10.1111/j.1460-9592.2011.03530.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Wan(김태완)
Shin, Yang Sik(신양식)
Chang, Chul Ho(장철호) ORCID logo https://orcid.org/0000-0001-5647-8298
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92889
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