Effects Of Caudal Analgesia On Oxidative Stress Response in Pediatric Cardiac Surgery

Betul Kocamer Simsek; Senem Koruk; Gokhan Gokaslan

Volume : IX, Issue : II, February - 2019

Effects Of Caudal Analgesia On Oxidative Stress Response in Pediatric Cardiac Surgery

Betul Kocamer Simsek, Senem Koruk, Gokhan Gokaslan

Abstract :

Objective: During congenital heart surgery in pediatric patients, factors such as pain, anxiety, hypoxia and hypercarbia those increase the sympathetic nervous system activity and consequently myocardial oxygen consumption, should be avoided. Therefore, it is important to provide effective perioperative analgesia. In this study we aimed to evaluate the effects of caudal analgesia on oxidative stress response, analgesia status, extubation time and CHIPPS scores. Material and methods: After Ethics Board approval from Gaziantep University Medical Faculty,47 childhood patients (aged 2 to 14 years) undergoing surgical ASD and VSD closure operation were enrolled in this study. Patients randomly divided into two groups, in 24 patients (group G), only routine general anesthesia was performed and in 23 patients (Group C) general anesthesia was performed with caudal anesthesia. In group C, caudal anesthesia was achieved with administration of 1mL/kg levobupivacaine % 0.25 and morphine 0.1 mg/kg mixture in to caudal epidural space just after intubation. Perioperative MAP, SpO2, HR, arterial bloodgas values, the amount of drug consumption, duration of CPB and ACC, TAS, TOS, OSI and glucose values, extubation time, intensive care and hospital stay and CHIPPS scores were recorded. Results: There was no difference between groups in terms of demographic data. Perioperative hemodynamics, arterial blood gas values, duration of anesthesia, CPB and ACC times were similar in two groups. Also preoperative TAS, TOS, OSI and glucose levels were showed no difference. After CPB,TAS value was significantly higher, glucose and TOS values were lower in group C, but OSI values showed no statistically significant difference. Although it was not statistically significant (p =0.051), TAS level was higher in the postoperative period in group C. TOS, OSI and glucose values were significantly lower in group C. Glucose values were ranging in normal values in both groups. Extubation time, ICU stay and hospital stay were significantly lower in group C (p<0.05). In all patients any serious adverse events due to anesthesia strategies were not encountered. Conclusion: In pediatric patients undergoing cardiac surgery,caudal analgesia in addition to general anesthesia reduces the stress response and suppresses oxidative stress.Therefore it does not only shorten the duration of extubation time,length of intensive care unit and hospital stay but also reduces the CHIPPS scores.