Caudal Block Reduces Demand of Sevoflurane for Adequate Depth of Anesthesia in Children.
10.4097/kjae.2007.52.1.29
- Author:
Jang Ho SONG
1
;
Hong Sik LEE
;
Byung Gun KIM
;
Hyun Kyoung LIM
;
Helen Ki SHINN
;
Sung Mee JUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Inha University, Incheon, Korea. hsleemd@inha.ac.kr
- Publication Type:Original Article
- Keywords:
bispectral Index;
caudal block;
children;
sevoflurane
- MeSH:
Adult;
Anesthesia*;
Child*;
Humans;
Hypnotics and Sedatives;
Intubation;
Lidocaine
- From:Korean Journal of Anesthesiology
2007;52(1):29-33
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: It is generally known that neuraxial anesthesia for adults reduces the demand for hypnotics needed for adequate sedation. Therefore, this study examined the effect of a preoperative caudal block on the general anesthetic requirements for an adequate depth of anesthesia in children. METHODS: Twenty children aged 3-5 years, who were set to undergo inguinal herniorraphy, were divided into 2 groups of 10 children each, normal saline and lidocaine groups. Tracheal intubation was performed. After setting up the bispectral index (BIS) monitor, a caudal block was administered to both groups differently, normal saline 0.7 ml/kg was administered to the normal saline group and 1.5% lidocaine 0.7 ml/kg was administered to lidocaine group. The end-tidal concentration of sevoflurane was maintained at 1.5 vol% for 10 minutes in the first patient in both groups, and the BIS value, was measured 6 times every 10 seconds, and averaged. When the BIS was > or = 50, the end-tidal concentration of sevoflurane was increased by 0.2 vol% in the subsequent patient. When the BIS was less than or equal to 50, the end-tidal concentration of sevoflurane was decreased by 0.2 vol% in the subsequent patient. The MAC(BIS50) in both groups was calculated using probit analysis. Relative median potency analysis was used to compare the results in both groups. RESULTS: The MAC(BIS50) of sevoflurane was significantly lower with a 1.5% lidocaine caudal block (1.40 vol% [95% CI, 1.25-1.55 vol%]) compared with the normal saline group (1.77 vol% [95% CI, 1.61-2.00 vol%]). CONCLUSIONS: A preoperative caudal block reduces the demand for sevoflurane required for an adequate depth of anesthesia, as measured by the BIS in children.
