Evaluation of hemodynamic changes after caudal anesthesia with intravenous dexamethasone

Abstract

Caudal anesthesia is a method of neuroaxial anesthesia that is used to perform surgeries or postoperative pain control in pediatric patients. Considering hemodynamic changes after caudal anesthesia, which mainly include bradycardia and hypotension, and due to the fact that corticosteroids are among the main drugs effective on the hemodynamic status control, the aim of this study was to evaluate the hemodynamic changes after caudal anesthesia with IV dexamethasone. If hemodynamic status have been imoroved with IV dexamethasone, a safe anesthesia method can be designed for these patients. Materials and Methods: This study was an interventional study that was conducted during 2019-2020 with 100 pediatric patients who underwent surgery in the Children's Hospital of Tabriz University of Medical Sciences. Patients premedicated with fentanyl (two micrograms per kg) and midazolam (0.01mg/kg), then anesthesia was induced with lidocaine 0.8mg/kg and propofol 3-5mg/kg and the appropriate size of LMA was implanted and secured; then caudal anesthesia was performed in the lateral positi using bupivacaine 0.2% (1ml/kg)p in the control group and the same dose of bupivacaine plus IV dexamethasone (0.5mg/kg maximum dose of 8mg) in the study group. Instead of dexamethasone, in control group, the same volume Distilled water was used, and isoflurane was used to anesthesia maintanence. Data were compared in SPSS 23 software with statistical tests and at a significance level of less than 0.05. Results: This study showed that there wasnot a statistically significant difference between systolic and diastolic blood pressure, arterial oxygen saturation and heart rate in the two groups (P>0.05. But it was noted that the incidence of complications between two groups were statistically significant, so that the incidence of complications in the dexamethasone group was significantly lower than the control group (P<0.05).