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Effect of caudal block on stress responses in children
Author(s) -
Tuncer Sema,
Yosunkaya Alper,
Reisli Ruhiye,
Tavlan Aybars,
CICekci Faruk,
Otelcioglu Seref
Publication year - 2004
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1328-0867.2004.01839.x
Subject(s) - medicine , anesthesia , basal (medicine) , prolactin , insulin , sevoflurane , midazolam , pediatric surgery , surgery , hormone , sedation
Background: The present study was performed during lower abdominal and genitourinary surgery, to assess the effects of caudal block on plasma cortisol, prolactin, insulin and glucose concentrations during and after surgery.Methods: Thirty male children aged 3−10 years who were scheduled for elective surgery, were selected for the study. The children were premedicated with oral midazolam 0.5 mg/kg. All children received induction with nitrous oxide in oxygen and sevoflurane. The children were randomly allocated into two groups: Group I, control group ( n = 15) and group II, caudal group ( n = 15). Anesthesia was maintained by face mask with the same agent in both groups. Caudal block was performed with 0.25% bupivacaine 2 mg/kg after induction of anesthesia in the caudal group. Blood samples were obtained after induction of anesthesia (T 0 ) in order to measure baseline concentrations of cortisol, prolactin, glucose and insulin. Additional samples were obtained 30 min after the start of surgery (T 1 ), and 60 min after the end of surgery (T 2 ).Results: All of the basal values (T 0 ) were within the normal ranges accepted by Meram Medical Faculty of Selcuk University for children of this age group and there were no differences between the groups ( P > 0.05). In both groups, glucose concentration increased at T 1 , compared with T 0 and T 2 values ( P < 0.05). However glucose concentration was lower in the caudal group than in the control group at T 1 ( P < 0.05). In both groups, prolactin concentration increased at T 1 , compared with T 0 ( P < 0.05). The mean plasma prolactin and cortisol concentration were lower in the caudal group than the control group at T 1 and T 2 ( P < 0.05). The mean insulin concentration was lower in the caudal group than the control group at T 2 ( P < 0.05).Conclusion: These results indicate that caudal anesthesia suppresses the metabolic and endocrine responses to stress associated with lower abdominal and genitourinary surgery in children.