Our Experience of using Caudal Anesthesia in "Small" Surgical Interventions in Newborns

Abstract

Aim of the Study: To study the effectiveness of anesthesia with caudal administration of ropivacaine in combination with intravenous administration of propofol in new borns with "small" surgeries. Material and Methods of the Study: The work was performed in the surgical clinic of the Azerbaijan Medical University. The study included 117 new borns operated on a one-sided or bilateral inguinal hernia, phimosis, paraphimosis and rectal atresia. After the patient completely fell asleep with propofol, a caudal block with ropivacaine was performed. The effectiveness of caudal anesthesia was assessed by hemodynamic indices and by the Robinson index, which was also called the "double product" or RPP (rate pressure product). To assess postoperative pain in newborns, we used the CRIES scale. Results of the Study: When the caudal block was performed, no serious complications were noted in the newborn. Throughout the period of the surgical intervention (duration averaged from 30 minutes to 1.5 hours), the central hemodynamics index was stable, while the fluctuations of the studied parameters were insignificant in comparison with the initial data. No patient required intravenous administration of fentanyl. Assessment of pain on the scale CRIES showed that the maximum score was 0-4. And this indicates the absence of pain within 6 hours after the operation. Conclusions: 1. Caudal blockade with ropivacaine provides effective anesthesia in new borns with "small" surgical interventions below the navel. 2. In neonates, a single caudal administration of ropivacaine at a dose of 3 mg/kg does not result in significant changes in hemodynamic parameters of the entire period of effective analgesia.