Abstract
BackgroundSurgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. ObjectivesThe aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. MethodsThis prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n=30) received general anesthesia and the other (n=30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. ResultsChildren who received a caudal block had significantly lower serum glucose (p< 0.01), cortisol concentrations (p< 0.01) and pain scores 3h (p= 0.002) and 6h (p= 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. ConclusionsThe combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication.
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