Comparison of Hemodynamic Changes between General Anesthesia and General Anesthesia plus Caudal Anesthesia with Ropivacaine in Children

Abstract

Tabriz Children's Hospital Center is a referral center in the field of pediatric surgery. Lower abdominal and perineal surgeries are currently performed in this center. Anesthesiologists currently use caudal anesthesia to reduce pre and postoperative pain in children. Few studies have been performed on hemodynamic changes after caudal anesthesia in children; considering the benefits of caudal anesthesia and its rare side effects and the increasing prevalence of general anesthesia in children, we compared the hemodynamic changes between general anesthesia and general anesthesia with caudal anesthesia. Materials and Methods: In this clinical trial study, 46 patients who underwent lower abdominal surgery in Tabriz Children's Hospital were randomly divided into two groups, one group under general anesthesia and the second group under general anesthesia plus caudal anesthesia with Ropivacaine. Demographic information (age and sex), weight, blood pressure and heart rate before and immediately after anesthesia, first, second and third 15 minutes after anesthesia and complications of anesthesia including hematoma, puncture, failed block, nausea and vomiting were recorded in both groups and then they were compared between the groups. Results: 23 children in the general anesthesia group and 23 patients in the general anesthesia with Ropivacaine caudal anesthesia group underwent surgery. Between the two groups in the terms of age (P value = 0.750), sex (P value = 0.608) and weight (P value = 0.521), there was no statistically significant difference. Although, in comparison between the two groups in the terms of diastolic blood pressure 15 minutes after anesthesia (P value = 0.007), systolic and diastolic blood pressure 30 minutes after anesthesia (P value = 0.020)(P value = 0.000), systolic and diastolic blood pressure 45 minutes after anesthesia (P value = 0.015)(P value = 0.001), respectively, statistically significant difference was observed. In the general anesthesia group, changes in systolic (P value = 0.025) and diastolic blood pressure (P value = 0.039) and heart rate (P value = 0.013) immediately after and before anesthesia was statistically significant. Also, in the general anesthesia plus caudal anesthesia group, changes in systolic blood pressure (P value = 0.005), diastolic blood pressure (P value = 0.010), and heart rate (P value = 0.009) immediately after anesthesia compared to before anesthesia showed statistically significant difference. There was no significant difference between the two groups in hemodynamic parameters changes such as systolic blood pressure (P value: 0.114) and heart rate (P value: 0.321), but diastolic blood pressure (P value: 0.009) showed statistically significant difference.