The Effect of Caudal Anesthesia Block on Perioperative Pain Control and Reduction of the Anesthetic Agent in Pediatric Infraumbilical Surgery

Gawe, Zeana Amer; Isa, Hasan M; Almashaur, Muatasem Mohamed; Haider, Fayza; Almulla, Khadija

doi:10.4103/aer.aer_64_22

Cited by 3 publications

(2 citation statements)

References 19 publications

(63 reference statements)

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“…Regional anesthesia is an established method of pain relief for children, with caudal anesthesia being the most commonly used due to its simplicity and safety (10,11). However, one drawback of caudal and single-shot epidurals is that they provide pain relief after surgery.…”

Section: Reviewmentioning

confidence: 99%

Efficacy, safety and complication of epidural analgesia in pediatrics

Bogari,

Abduljaleel,

Al shbib

et al. 2023

JOHS

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For managing different types of pain, epidural analgesia is widely used in adults. Its application in children is less common and subject to discussion. This article seeks to investigate the evidence concerning the efficacy, safety, and potential complications of analgesia in patients. We analyzed randomized controlled trials, observational studies, and systematic reviews that compared analgesia to pain management methods or placebo for children undergoing surgery or experiencing acute or chronic pain. The findings indicated that epidural analgesia effectively reduced pain intensity and opioid consumption in children undergoing types of surgeries—especially thoracic, abdominal, and orthopedic procedures. Epidural analgesia has also been proven to create satisfaction and improve the quality of life for children experiencing cancer pain or sickle cell crisis. The use of analgesia may result in some side effects, like itchiness, feelings of nausea, vomiting, difficulty urinating, and low blood pressure. Serious complications such as hematoma, infection, nerve damage, or respiratory depression were occurrences. Affected less than 1% of patients. In summary, we conclude that epidural analgesia is an option for pain management as it offers relief with minimal risk of significant complications. Nonetheless, further high-quality studies are required to compare techniques, medications, and dosages of analgesia, specifically in children, while also evaluating its long-term outcomes.

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Section: Reviewmentioning

confidence: 99%

Efficacy, safety and complication of epidural analgesia in pediatrics

Bogari,

Abduljaleel,

Al shbib

et al. 2023

JOHS

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“…1 Caudal epidural block is a central neuraxial technique useful in a variety of infra-umbilical surgeries in pediatric patients for both intra-operative and post-operative analgesia. 4,5 Quality and level of analgesia depend on dose, volume and concentration of injected local anesthetic agent. 4 It is a simple and safe technique in pediatric patients for pain relief.…”

Section: Introductionmentioning

confidence: 99%

Comparison of post-operative analgesia with caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia

Hariharan,

Gupta,

Nagpal

et al. 2024

IJCA

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Post-operative pain relief following pediatric abdominal surgery is of paramount consideration and caudal block is still a popular, easy as well as safe analgesic technique for effective analgesia in children. With the advent of newer local anaesthetics, there has been a renewed interest in pediatric caudal blocks after lower abdominal surgeries following general anaesthesia. The aim of our study was to compare the efficacy and duration of postoperative analgesia using caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia.: The study was conducted on sixty, ASA grade 1, pediatric patients of age 2 to 6 years, of either sex, posted for elective infraumbilical surgery under general anaesthesia. They were randomly divided in two groups of 30 patients each. Group 1: - (n = 30) received caudal block with injection Ropivacaine, 0.25%, 1ml/kg. Group 2: - (n = 30) received caudal block with injection Levobupivacaine, 0.25%, 1ml/kg. Comparative, randomized, single blinded, observational study. : The demographic data was comparable in both the groups. Postoperatively, the quality of analgesia was assessed by the MOP (Modified Objective Pain Scale) score. Duration of postoperative analgesia was assessed by noting the time of giving rescue analgesia in the post-operative period. We also noted side effects, if any in both the groups. The quality of analgesia was found to be similar with both the drug groups (p value >0.05). The duration of analgesia was longer and statistically significant (p value = 0.0006) in the Ropivacaine group (8.43 ± 0.77 hours) as compared to the Levobupivacaine group (7.03 ± 2.03 hours). Statistically significant difference (P value = 0.026) was seen in the requirement rescue analgesia between Ropivacaine (3.33%) and Levobupivacaine (26.67%) groups. There were no major side effects in either of the groups, apart from a single patient out of 30 patients of Levobupivacaine group who had vomiting, compared with none in the Ropivacaine group.We conclude that caudal block with 0.25% Ropivacaine has a longer duration of action as compared to 0.25% Levobupivacaine in children undergoing infraumbilical surgery under general anaesthesia. Both Ropivacaine and Levobupivacaine, have similar quality of postoperative analgesia and side effect profile.

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A case of successful comprehensive treatment of necrotizing enterocolitis in a newborn child

Kurochkin,

Davydova,

Denysenko

et al. 2023

Modern Medical Technology

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Necrotizing enterocolitis is an inflammatory disease caused by infection and hypoxic–ischemic damage of the intestinal mucosa, which leads to generalization with the development of a systemic inflammatory response. The pathogenetic mechanisms leading to intestinal wall damage are ischemia and pain. Therefore, the use of central neuraxial blocks, which provide the analgesic effect and preganglionic blockade of the sympathetic nervous system, is pathogenetically justified. The aim of the work is to acquaint practitioners with the case of successful comprehensive treatment using neuraxial blocks in a newborn with necrotizing enterocolitis. Materials and methods. The child was treated at the Department of Anesthesiology and Intensive Care for Newborns of Zaporizhzhia City Pediatric Hospital No. 5. He underwent clinical and biochemical blood tests, microbiological, radiological and ultrasound examinations using hospital equipment. Results. A child was operated due to suspected intestinal perforation and pneumoperitoneum. It was found that throughout the small and large intestines had multiple hemorrhages and air bubbles in the subserosa, but no perforation sites were found. Subsequently, the child underwent conservative treatment with antibacterial therapy according to the de-escalation principle, antifungal therapy, intravenous immunoglobulins, total parenteral nutrition. In addition to this standard treatment, the child underwent caudal-epidural blocks twice a day for a week in the postoperative period for effective analgesia, improvement of microcirculation and splanchnic blood flow. Conclusions. Surgical intervention performed on a newborn child with the second stage of necrotizing enterocolitis (intestinal pneumatosis), when its perforation could not be excluded, did not significantly affect the course of the disease, so the positive outcome can be considered the result of successful comprehensive intensive care. In our opinion, the decisive factor that influenced the positive treatment outcomes (prevention of perforation and peritonitis) was the effect of neuraxial caudal epidural blocks, which contributed to the improvement of microcirculation in the splanchnic area, elimination of intestinal ischemia and effective anesthesia.

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The Effect of Caudal Anesthesia Block on Perioperative Pain Control and Reduction of the Anesthetic Agent in Pediatric Infraumbilical Surgery

Cited by 3 publications

References 19 publications

Efficacy, safety and complication of epidural analgesia in pediatrics

Efficacy, safety and complication of epidural analgesia in pediatrics

Comparison of post-operative analgesia with caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia

A case of successful comprehensive treatment of necrotizing enterocolitis in a newborn child

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