Evaluating the effect of caudal epidural block on optic nerve sheath diameter in pediatric patients: randomized controlled study.

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Erkan Cem Celik, Mirac Selcen Ozkal Yalin, Binali Firinci, Irem Ates, Muhammed Enes Aydin, Ali Ahiskalioglu
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引用次数: 0

Abstract

Introduction: Caudal epidural block is a widely performed procedure for postoperative pain control of pediatric patients. As the local anesthetic acts by spreading cranially after caudal block, it may lead to several effects on the cerebrospinal fluid and intracranial region.

Method: Children aged 1-7, ASA I-II were included in this study. The patient population was assigned into two groups as the Caudal Block Group (Group CB) and the Control Group (Group C) Caudal block with 0.25% bupivacaine 1 ml/kg was performed on patients in Group CB. Optic nerve sheath diameter was measured at the following timeline: T0: Following laryngeal mask placement, T1: Following caudal block. T15:15. min, T30:30. min. Heart rate, non-invasive blood pressure, SpO2 and PCO2 values were also recorded at every time point.

Results: There was no significant difference between two groups considering demographic data, intraoperative hemodynamic parameters, intraoperative SpO2 and PCO2 values. While optic nerve sheath diameter findings were not significantly different between the groups at T0 and T1 points(P > 0.05), the measurements at T15(4.18 ± 0.56 for Group C and 4.62 ± 0.47 for Group CB, P = 0.006) and T30(4.20 ± 0.53 for Group C and 4.76 ± 0.52 for Group CB) were statistically higher in the Caudal Group.

Conclusion: Evaluation of optic nerve sheath diameter has high diagnostic precision for detecting increased intracranial pressure in children. The findings in this study display that local anesthetic applied for caudal block in pediatric surgeries spread cranially resulting in an increase in the intracranial pressure and optic nerve sheath diameter. However, this increase does not cause intraoperative hemodynamic changes.

评估尾硬膜外阻滞对儿科患者视神经鞘直径的影响:随机对照研究。
尾侧硬膜外阻滞是一种广泛应用于儿科患者术后疼痛控制的手术。由于局麻药在尾侧阻滞后通过颅脑扩散起作用,可能对脑脊液和颅内区域产生多种影响。方法:选取1-7岁ASA I-II级儿童作为研究对象。将患者人群分为两组,分别为尾侧阻滞组(CB组)和对照组(C组)。CB组患者采用0.25%布比卡因1 ml/kg的尾侧阻滞。视神经鞘直径在以下时间点测量:T0:喉罩放置后,T1:尾侧阻滞后。T15:15。分钟,T30:30。同时记录各时间点心率、无创血压、SpO2、PCO2值。结果:两组患者人口学资料、术中血流动力学参数、术中SpO2、PCO2值比较,差异无统计学意义。T0和T1点视神经鞘直径差异无统计学意义(P < 0.05), T15点(C组4.18±0.56,CB组4.62±0.47,P = 0.006)和T30点(C组4.20±0.53,CB组4.76±0.52)视神经鞘直径差异有统计学意义(P < 0.05)。结论:评价视神经鞘直径对儿童颅内压增高有较高的诊断准确率。本研究结果显示,小儿手术中用于尾侧阻滞的局麻药向颅内扩散,导致颅内压和视神经鞘直径增加。然而,这种增加不会引起术中血流动力学的改变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Anesthesiology
BMC Anesthesiology ANESTHESIOLOGY-
CiteScore
3.50
自引率
4.50%
发文量
349
审稿时长
>12 weeks
期刊介绍: BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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