THE EFFECT OF PREEMPTIVE CAUDAL BLOCK ON THE EMERGENCE CHARACTERISTICS AFTER SEVOFLURANE ANESTHESIA IN CHILDREN
J. C. Que, R. T. D. Policarpio
Department of Anesthesiology, University of Santo Tomas Hospital, Manila, Philippines
Purpose of Study
Emergence agitation (EA) is a well-known phenomenon observed during emergence from inhalational anesthesia, with a reported incidence of 12% to 30% in children.1,2 A clear relationship between emergence agitation and the perception of pain following rapid recovery from general anesthesia has not been established. The objective of this study was to determine the effect of preemptive caudal block on the incidence, severity, and duration of EA after sevoflurane anesthesia in children undergoing minor urologic surgery.
Method
After obtaining approval from the local ethics committee, 72 ASA I and II patients, aged 3 – 10 years, scheduled for minor urologic surgery were randomly allocated to two groups: 36 children received caudal analgesia with bupivacaine 0.25% prior to surgery, and the remaining 36 received pure general anesthesia (GA) with sevoflurane. At the post-anesthetic care unit, the incidence, duration and level of agitation using the EA scale,1 the duration and level of sedation using the sedation scale, and the duration and severity of pain using the objective pain scale were recorded and compared between the two groups.
Result
42.67% of the 72 children developed EA, with no difference in the incidence and duration of EA between the two groups. Patients in the caudal group had significantly lower agitation scores than the GA group (p<0.05).
Conclusion
Preemptive caudal analgesia reduced the severity of EA, but not the incidence and duration in children undergoing minor urologic surgery with sevoflurane anesthesia.
Time of Presentation
Sunday 14 May 2006 - 1030-1200
References
1. Cole J, Murray D, McAllister J, et al. Emergence behavior in children: Defining the incidence of excitement and agitation following anaesthesia. Pediatr Anesth 2002; 12: 442-447.
2. Voepel-Lewis T, Malviya S, Tait AR. A prospective cohort study of emergence agitation in the pediatric postanesthetic care unit. Anesth Analg 2003; 96: 1625-30.
