Caudal Epidural Anesthesia, Hemodynamic Changes, Infants, Intrathecal Anesthesia, Laparoscopic Inguinal Herniorrhaphy, Stress Response
Conditions
Brief summary
The aim of this work was to assess stress response and hemodynamic changes associated with intrathecal anesthesia versus caudal epidural anesthesia in infants undergoing laparoscopic inguinal herniorrhaphy.
Detailed description
Inguinal hernia repair is the most frequent surgical procedure in early childhood. Various regional anesthetic techniques have been employed to provide optimum intraoperative and postoperative pain control after this procedure. Introduced decades ago, the use of intrathecal (spinal) anesthesia and caudal block in procedures for different types of laparoscopic abdominal surgery is safe and efficient. Caudal block is now frequently used in intraoperative and postoperative analgesia for pediatric surgery. In infants and children, central neuraxial block is an important modality for acute postoperative analgesia in addition to combined anesthesia, the goals of postoperative analgesia in children are pain eradication, expedient recovery to daily activities, and prevention of progression of acute postsurgical pain to chronic pain or hyperalgesia
Interventions
DRUGGeneral anesthesia
Patients received general anesthesia
Patients received intrathecal Anesthesia
DRUGCaudal block
Patients received caudal epidural anesthesia.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Months to 1 Years
Healthy volunteers
No
Inclusion criteria
* Age from full term one month to one year. * Both sexes. * Patients with clinical criteria of laparoscopic inguinal herniorrhaphy.
Exclusion criteria
* Refusal of patients' parents. * Diseases of the central nervous system. * Patients with metabolic and coagulation defects. * Pre-term infant. * Infection at the site of injection. * Congenital anomaly in vertebral column. * Patient treated with corticosteroids. * Patients with respiratory dysfunction.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serum glucose level | 24 hours postoperatively | Serum glucose level was recorded pre-operative and just postoperative and 6, 12, and 24h postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Serum cortisol level | 24 hours postoperatively | Serum cortisol level was recorded pre-operative and just postoperative and 6, 12, and 24h postoperatively. |
| Heart rate | Till the end of surgery (Up to 1 hour) | Heart rate was recorded at baseline, after induction, then every 15 minutes till the end of surgery. |
| Mean arterial pressure | Till the end of surgery (Up to 1 hour) | Mean arterial pressure was recorded at baseline, after induction, then every 15 minutes till the end of surgery. |
| Intraoperative anesthetic consumption | Intraoperatively | Intraoperative anesthetic consumption of sevoflurane was recorded. |
| Total analgesics consumption | 24 hours postoperatively | Intravenous Tramadol 1 mg/kg is administered intravenously in the event that the Face, Legs, Activity, Cry, Consolability (FLACC) score exceeds 4 within the first 24 hours following surgery. |
Countries
Egypt
Outcome results
None listed