The effects of caudal anesthesia combined with general anesthesia on the postoperative analgesia and stress response in pediatric patients

The aim of this study is to evaluate the effects of caudal block with bupivacaine and levobupivacaine on children gone congenital hip dislocation under general anaesthesiaTotal of 45 patients in ASA I-II group between 2 and 10 years old age enrolled to study. All were scheduled for congenital hip dislocation operation. Patients were divided into three groups. In Group I bupivacaine (0.25%), Group II levobupivacaine (0.25%) was used for caudal block. In Group III patients nothing was done except general anesthesia. Intraoperatively hemodynamic parameters mean arterial blood pressure, heart rate, oxygen saturation, respiratory rate were measured at the 1st, 5th, 15th, 20th, 30th and 45th minutes. End tidal sevoflurane concentrations were measured also at the same periods. In Group III the inspirited end tidal sevoflurane concentration values were higher than the other groups during the intraoperative period. In Group III the analgesic need was higher than the other groups during the first 90 minutes postoperatively. There was no differences between groups howewer glucose levels were significantly lower in Group 1 compared to Group 3 intraoperatively. Cortisol levels of Group 1 and Group 3 and insuline levels of Group 2 and glucose levels of Group 1, Group 2, Group 3 and prolactine levels of Group 2 were significantly higher intraoperatively and postoperatively compared to preoperative levels. Glucose levels of Group 2, insuline levels of Group 1 and Group 3 postoperatively were higher than those preoperative values. Also, prolactine levels measured intraoperatively in the Group 1 and Group 3 were higher than their preoperative valuesIn conclusion, caudal anesthesia added to general anesthesia in pediatric patients may have a role on depressing the hemodynamic changes secondary to surgery. It also limits the hormonal release caused by surgery. On the other hand this combination decreased the use of inhalation anesthetics and decreased the analgesic need postoperatively significantly.Key words: Caudal anesthesia, Surgery stress hormones, Bupivacaine, Levobupivacaine, Postoperatively analgesia