The management of postoperative pain in children with caudal blocks

Hasani, Antigona; Soljakova, Marija; Ustalar-Ozgen, Serpil

doi:10.1080/22201173.2011.10872809

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…27 Another study concluded that caudal block with bupivacaine and midazolam provided better postoperative pain relief when applied before surgical incision than when it was given after surgical incision. 28 The strength of the present study is that preemptive multimodal analgesia was as effective as a preemptive caudal block without any deleterious changes in the hemodynamics in the target group.…”

Section: Discussionmentioning

confidence: 69%

Effectiveness of multimodal preemptive analgesia in major pediatric abdominal cancer surgery

Ghobrial

Shaker

2019

APIC

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Objective: evaluate efficacy of combining multimodal analgesia and local anesthetic infiltration compared with caudal analgesia among pediatric patients undergoing major abdominal pediatric cancer surgeryMethodology: This randomized controlled pilot study was carried out at postoperative care unit of our institution. This pilot study enrolled 90 children ASA I and II with cancer scheduled for major abdominal surgery through a midline incision. Intervention: patients were randomly divided into three equal groups. The morphine group received IV morphine at a dose of 0.1 mg/kg after induction of anesthesia. The caudal group underwent caudal block. The multimodal group received paracetamol, ketorolac and ketamine infusion, with local wound infiltration of levobupivacaine before skin incision and at the end of surgery. After surgery, all patients were maintained on PCA morphine postoperatively. Primary outcome measure was total postoperative morphine consumption. The secondary endpoints were VAS score for pain, the time to first PCA bolus, and the number of PCA doses.Results: that there were no between-group differences in the baseline characteristics of the participants. The three analgesic modalities provided adequate pain relief for up to 24 h. The multimodal and caudal groups did not significantly differ in terms of total morphine consumption (p = 0.521), time to first analgesic bolus (p = 0.136), or the number of total and active PCA boluses (p = 0.260 and p = 0.904, respectively). Both groups were superior to the morphine group regarding morphine consumption, time to first analgesic bolus, and the number of total and active PCA bolusesConclusion: Preemptive multimodal analgesia and caudal block offered comparable efficacy in the target population.Trial registration: clinicaltrial.gov with no. NCT03580980.Citation: Ghobrial HZ, Shaker EH. Effectiveness of multimodal preemptive analgesia in major pediatric abdominal cancer surgery. Anaesth pain & intensiv care 2019;23(3):256-262Received & Reviewed: 16, 21 August 2019. Accepted: 28 August 2019

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Section: Discussionmentioning

confidence: 69%

Effectiveness of multimodal preemptive analgesia in major pediatric abdominal cancer surgery

Ghobrial

Shaker

2019

APIC

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Comparison of Preoperative and Postoperative Ultrasound-Guided Caudal Block Analgesia for Lower Limb Surgeries in Pediatrics: A Randomized Controlled Trials

Nikoubakht,

Shafeinia,

Ahmadi

et al. 2024

Iran J Pediatr

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Background: Evaluating pain after surgery is particularly important in children due to their limited ability to communicate effectively. The intensity, duration, and threshold of pain make it challenging to assess in this age group. Objectives: The aim of this study was to compare the effects of ultrasound-guided caudal block at different timings on children's pain and drug consumption during unilateral knee osteotomy surgery. Methods: In a randomized clinical trial, fifty patients were randomly included in the study. The patients were children aged 2 - 6 years, candidates for unilateral osteotomy surgery under general anesthesia with total IV anesthesia (TIVA). The patients were divided into two groups based on the timing of the caudal block: The first group received the block after induction, and the second group received it after surgery and before extubation. Results: There was no statistically significant difference between the two groups in terms of the average amount of Propofol and narcotic consumption during recovery at different time points (P > 0.05). However, significant differences in pain levels were observed during the operation at 60 minutes (P-value < 0.001) and 120 minutes (P-value = 0.006) between the two groups. Pain scores at the start of recovery and at 2, 4, 6, 12, and 24 hours postoperatively were significantly lower in the second group than in the first group. Additionally, the mean difference in Bispectral Index (BIS) at 60 minutes between the two groups was significant (P-value = 0.003), but there was no significant difference at 120 minutes (P-value = 0.896). The second group consistently had significantly lower pain levels than the first group at all times. Conclusions: Based on the results of this study, patients who received a caudal block had lower pain scores, and performing the block before extubation had more beneficial effects on postoperative pain management in children undergoing osteotomy surgery than performing it after induction.

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The management of postoperative pain in children with caudal blocks

Cited by 2 publications

References 14 publications

Effectiveness of multimodal preemptive analgesia in major pediatric abdominal cancer surgery

Effectiveness of multimodal preemptive analgesia in major pediatric abdominal cancer surgery

Comparison of Preoperative and Postoperative Ultrasound-Guided Caudal Block Analgesia for Lower Limb Surgeries in Pediatrics: A Randomized Controlled Trials

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