Izvorni znanstveni članak

Comparison of needed end-tidal concentration of sevoflurane in children with balanced intravenous intraoperative analgesia versus epid ral caudal intraoperative analgesia: prospective randomized trial

MILENA KREMESEC ; Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
ŠPELA ŠTUPNIK ; Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
MENSUR SALIHOVIĆ ; Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
STELA MARIĆ ; University Hospital Center »Sestre milosrdnice« Clinic for tumors, Department of Anaesthesiology, Zagreb, Croatia
VESNA NOVAK JANKOVIČ ; Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
VESNA PAVER ERŽEN ; Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia

Sažetak

Background and Purpose: It was already shown that neuroaxial anaesthesia has sedative effects. The scope of our study was to find out whether the combined caudal epidural block with 0.19% bupivacaine decreases the sevoflurane requirement because of its synergistic hypnotic effect in comparison to balanced anaesthesia with intravenous alfentanil and sevoflurane in children.

Materials and Methods: Forty boys aged 1–7 years were included in the study; they were undergoing elective orchidopexy. Children were randomized in two groups: A (caudal block) and B (IV analgesia with opioid). Each child in group A received a caudal epidural block in a dosage of 0.19% bupivacaine 2.5 mg/kg. In group B the loading dose of alfentanil was 20 μg/kg, followed by intermittent doses of 10–20 μg/kg. Anaesthesia hypnosis was controlled by the clinical parameters and by the Bispectral Index monitor (BIS). We measured end-tidal sevoflurane concentration (sevoE) at 5-minute intervals. The aim was to maintain the BIS values near 50 through increments or decrements in sevoflurane concentration.

Results and Conclusion: No difference in end-tidal sevoflurane concentration (sevoE) values was observed between the two groups.We do suppose that due to the low level of caudal blockwe could not confirm synergism between caudal epidural block with local anaesthetic and sevoflurane.

Ključne riječi

epidural caudal anaesthesia; sedative effects; sevoflurane; alfentanil; BIS; children

Hrčak ID:

68925

URI

https://hrcak.srce.hr/68925

Datum izdavanja:

1.6.2011.

Posjeta: 1.610 *