The effects of caudal local anesthesia blockade on the Bispectral Index during general anesthesia in children

Davidson, Andrew; Ironfield, Craig M.; Skinner, Adam; Frawley, Geoff

doi:10.1111/j.1460-9592.2006.01868.x

Cited by 25 publications

(16 citation statements)

References 15 publications

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“…Similar synergism in children was confirmed by Davidson et al. (12). They studied the effect of caudal blockade on BIS, in unstimulated children under general anesthesia with sevoflurane.…”

Section: Discussionsupporting

confidence: 84%

Depth of sedation using Cerebral State Index in infants undergoing spinal anesthesia

Disma¹,

Tuo²,

Astuto³

et al. 2009

Pediatric Anesthesia

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“…Similar synergism in children was confirmed by Davidson et al. (12). They studied the effect of caudal blockade on BIS, in unstimulated children under general anesthesia with sevoflurane.…”

Section: Discussionsupporting

confidence: 84%

Depth of sedation using Cerebral State Index in infants undergoing spinal anesthesia

Disma¹,

Tuo²,

Astuto³

et al. 2009

Pediatric Anesthesia

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“…Davidson et al demonstrated that a caudal block was associated with a five points decrease in BIS values compared with patients without a caudal block. The authors also pointed out that the clinical relevance of a decrease in five points is questionable (25).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the aepEX™ monitor of hypnotic depth in pediatric patients receiving propofol–remifentanil anesthesia

Cheung

Scoones

Hoeks

et al. 2013

Pediatric Anesthesia

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“…[31] However, authors do not discuss the effects of deafferentation produced by the caudal block. [32] None of these studies have calculated the level of sedation or emergence time. In a recent study by Shobha Malviya reduced ED has been shown to have strong association with increased sleepiness after intravenous Clonidine but under adequate analgesic cover.…”

Section: Discussionmentioning

confidence: 99%

Caudal block and emergence delirium in pediatric patients: Is it analgesia or sedation?

Sinha

Sood

2012

Saudi J Anaesth

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Background:Emergence delirium (ED) although a short-lived and self-limiting phenomenon, makes a child prone to injury in the immediate postoperative period and hence is a cause of concern not only to the pediatric anesthesiologist, surgeons, and post anesthesia care unit staff but also amongst parents. Additional medication to quieten the child offsets the potential benefits of rapid emergence and delays recovery in day care settings. There is conflicting evidence of influence of analgesia and sedation following anesthesia on emergence agitation. We hypothesized that an anesthetic technique which improves analgesia and prolongs emergence time will reduce the incidence of ED. We selected ketamine as adjuvant to caudal block for this purpose.Methods:This randomized, double blind prospective study was performed in 150 premedicated children ASA I, II, aged 2 to 8 years who were randomly assigned to either group B (caudal with bupivacaine), BK (bupivacaine and ketamine), or NC (no caudal), soon after LMA placement. Recovery characteristics and complications were recorded.Results:Emergence time, duration of pain relief, and Pediatric Anesthesia Emergence Delirium (PAED) scores were significantly higher in the NC group (P<0.05). Duration of analgesia and emergence time were significantly more in group BK than groups B and NC. However, the discharge readiness was comparable between all groups. No patient in BK group required to be given any medication to treat ED.Conclusion:Emergence time as well as duration of analgesia have significant influence on incidence of emergence delirium. Ketamine, as caudal adjuvant is a promising agent to protect against ED in children, following sevoflurane anesthesia.

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The effects of caudal local anesthesia blockade on the Bispectral Index during general anesthesia in children

Abstract: Caudal blockade decreased the degree of arousal, as measured by BIS, in unstimulated children aged 2-5 years. No change in arousal was detected in infants.

Cited by 25 publications

References 15 publications

Depth of sedation using Cerebral State Index in infants undergoing spinal anesthesia

Depth of sedation using Cerebral State Index in infants undergoing spinal anesthesia

Evaluation of the aepEX™ monitor of hypnotic depth in pediatric patients receiving propofol–remifentanil anesthesia

Caudal block and emergence delirium in pediatric patients: Is it analgesia or sedation?

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