Effects of caudal analgesia on oxidative stress response in pediatric cardiac surgery

During congenital heart surgery in pediatric patients, factors such as the pain, anxiety, hypoxia and hypercarbia that increase the sympathetic nervous system activity and consequently myocardial oxygen consumption, should be avoided. Therefore, it is important to provide effective perioperative analgesia in these patients. In this study we aimed to determine the effects of caudal analgesia on oxidative stress response, analgesia status, extubation time and CHIPPS scores.After Ethics Board approval from Gaziantep University Medical Faculty 47 children ages between 2-14, undergoing ASD and VSD correction operation were included the study. Patients randomly divided in two groups, the first group (group G) 24 patients received only routine general anesthesia, the second group (group K) general anesthesia with caudal anesthesia was performed in 23 patients. In group K, 1 mL/kg levobupivacaine % 0.25 and morphine 0.1 mg/ kg mixture administered to caudal epidural space. Perioperative MAP (mean arterial pressure), SpO2 (oxygen saturation) HR (heart rate), arterial blood gas values, the amount of drug administration, duration of CPB (cardio-pulmonary bypass) and ACC (aortic cross-clemp), TAS (total antioxidant status), TOS total oksidant status), OSI (oxydative stress index) and glucose values, extubation time, intensive care and hospital stay and CHIPPS scores were recorded.There was no difference between groups in terms of demographic data. Perioperative hemodynamics, arterial blood gas values and duration of anesthesia, CPB and ACC time did not differ between groups. Preoperative TAS, TOS, OSI and glucose levels showed no difference. After CPB, TAS value was significantly higher, glucose and TOS values were lower in group K, but OSI value showed no difference statistical significant. TAS level was higher in the postoperative period in group K, but was not statistically significant (p = 0.051), TOS, OSI and glucose values were significantly lower in group K. Glucose values ranged from normal values in both groups. Extubation time, ICU stay and hospital stay were significantly lower in group K (p<0.05). Patients with any serious adverse events were encountered.Caudal anesthesia additional to general anesthesia in children undergoing congenital cardiac surgery reduces the stress response, suppresses oxidative stress, shortens the duration of extubation time, length of intensive care and hospital stay and reduces the CHIPPS scores.