Çocuklarda kaudal anestezide sabit doz, farklı volüm ve konsantrasyonda levobupivakainin etkilerinin karşılaştırılması

A comparison of the effects of caudal anesthesia with constant dosage of levobupivacaine in different volumes and concentrations in children

İnci KARA, Ali YÜCEAKTAŞ, Jale Bengi ÇELİK, Seza APİLİOĞULLARI, Ahmet TOPAL

Abstract

Objective: The effects of two different volumes and concentra- Material and Methods: Levobupivacaine at a dose of 2 mg/tions of a fixed dose of levobupivacaine on quality and postop- kg was given in a 1 mL/kg (n=20) volume or 0.5 mL/kg (n=20)erative analgesia of caudal block in children were compared. volume to forty children aged 3-8 yr undergoing urogenitalsurgery for caudal blockage. Intraoperative hemodynamicresponses requiring an increase in inspired sevoflurane con-centration, and duration of postoperative analgesia were theprimary outcome measures.Objective: The effects of two different volumes and concentra- Material and Methods: Levobupivacaine at a dose of 2 mg/tions of a fixed dose of levobupivacaine on quality and postop- kg was given in a 1 mL/kg (n=20) volume or 0.5 mL/kg (n=20)erative analgesia of caudal block in children were compared. volume to forty children aged 3-8 yr undergoing urogenitalsurgery for caudal blockage. Intraoperative hemodynamicresponses requiring an increase in inspired sevoflurane concentration, and duration of postoperative analgesia were theprimary outcome measures.Objective: The effects of two different volumes and concentra- Material and Methods: Levobupivacaine at a dose of 2 mg/tions of a fixed dose of levobupivacaine on quality and postop- kg was given in a 1 mL/kg (n=20) volume or 0.5 mL/kg (n=20)erative analgesia of caudal block in children were compared. volume to forty children aged 3-8 yr undergoing urogenitalsurgery for caudal blockage. Intraoperative hemodynamicresponses requiring an increase in inspired sevoflurane concentration, and duration of postoperative analgesia were theprimary outcome measures.Results: There were no patients in any group who requiredan increase in inspired sevoflurane concentration to blockthe hemodynamic response during the operation. Duration ofanalgesia was significantly longer in Group H than in GroupL (825±103 min vs. 587±98 min respectively, p=0.029). No signs of motor block were observed after the first postoperative hour in any of the patients.Conclusion: Caudal block with a high volume/low concentration of levobupivacaine provides longer duration of postoperative analgesia compared to low volume/high concentration of levobupivacaine in children.

Özet

Amaç: Sabit dozda kullanılan levobupivakainin iki farklı volüm ve konsantrasyonunun çocuklarda kaudal blok kalitesi ve postoperatif analjezi üzerine etkileri kıyaslandı. Gereç ve Yöntemler: Ürogenital cerrahi geçirecek 3-8 yaş arası 40 çocuğa kaudal blok için 2 mg/kg levobupivakain, yüksek (1 mL/kg; Grup Y; n=20) veya düşük (0,5 mL/kg; Grup D; n=20)hacimde uygulandı. İnspiratuar sevofluran konsantrasyonunu artırmayı gerektiren intraoperatif hemodinamik yanıtlar vepostoperatif analjezi süresi değerlendirilen öncelikli parametrelerdi. Bulgular: Her iki grupta da inspire edilen sevofluran konsantrasyonunu artırmayı gerektirecek hemodinamik yanıt gözlenen hasta yoktu. Analjezi süresi Grup Y de Grup D’ye göre anlamlı olarak uzundu (sırasıyla 825±103 dk ve 587±98 dk; p=0,029).Operasyon sonrası ilk saatte hastaların hiçbirinde motor blok bulgusu gözlenmedi. Sonuç: Levobupivakainin yüksek volüm/düşük konsantrasyonu ile uygulanan kaudal blok, düşük volüm/yüksek konsantrasyonu kıyaslandığında daha uzun süre postoperatif analjezi sağlar.