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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 ; Yang-Sik Shin ; Young Mi Kim ; Tae Wan Kim ; Chul Ho Chang 
Citation
 Pediatric Anesthesia, Vol.21(4) : 394~398, 2011 
Journal Title
 Pediatric Anesthesia 
ISSN
 1155-5645 
Issue Date
2011
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/92889
DOI
10.1111/j.1460-9592.2011.03530.x
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Anesthesiology and Pain Medicine
Yonsei Authors
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Link
 http://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2011.03530.x/abstract
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