Effects of caudal block in pediatric surgical patients: a randomized clinical trial
Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoper...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Anna Uram Benka [verfasserIn] Marina Pandurov [verfasserIn] Izabella Fabri Galambos [verfasserIn] Goran Rakić [verfasserIn] Vladimir Vrsajkov [verfasserIn] Biljana Drašković [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
In: Brazilian Journal of Anesthesiology - Elsevier, 2018, 70(2020), 2, Seite 97-103 |
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| Übergeordnetes Werk: |
volume:70 ; year:2020 ; number:2 ; pages:97-103 |
| Links: |
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| DOI / URN: |
10.1016/j.bjane.2020.02.007 |
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| Katalog-ID: |
DOAJ084551380 |
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| 245 | 1 | 0 | |a Effects of caudal block in pediatric surgical patients: a randomized clinical trial |
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| 520 | |a Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. | ||
| 650 | 4 | |a Bloqueio caudal | |
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| 700 | 0 | |a Goran Rakić |e verfasserin |4 aut | |
| 700 | 0 | |a Vladimir Vrsajkov |e verfasserin |4 aut | |
| 700 | 0 | |a Biljana Drašković |e verfasserin |4 aut | |
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10.1016/j.bjane.2020.02.007 doi (DE-627)DOAJ084551380 (DE-599)DOAJ6db44a471bd64da09cf194553592ce9c DE-627 ger DE-627 rakwb eng RD78.3-87.3 Anna Uram Benka verfasserin aut Effects of caudal block in pediatric surgical patients: a randomized clinical trial 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. Bloqueio caudal Reposta ao estresse Anestesia geral Crianças Anesthesiology Marina Pandurov verfasserin aut Izabella Fabri Galambos verfasserin aut Goran Rakić verfasserin aut Vladimir Vrsajkov verfasserin aut Biljana Drašković verfasserin aut In Brazilian Journal of Anesthesiology Elsevier, 2018 70(2020), 2, Seite 97-103 (DE-627)DOAJ000117110 23522291 nnns volume:70 year:2020 number:2 pages:97-103 https://doi.org/10.1016/j.bjane.2020.02.007 kostenfrei https://doaj.org/article/6db44a471bd64da09cf194553592ce9c kostenfrei http://www.sciencedirect.com/science/article/pii/S0104001420300075 kostenfrei https://doaj.org/toc/0104-0014 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 70 2020 2 97-103 |
| spelling |
10.1016/j.bjane.2020.02.007 doi (DE-627)DOAJ084551380 (DE-599)DOAJ6db44a471bd64da09cf194553592ce9c DE-627 ger DE-627 rakwb eng RD78.3-87.3 Anna Uram Benka verfasserin aut Effects of caudal block in pediatric surgical patients: a randomized clinical trial 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. Bloqueio caudal Reposta ao estresse Anestesia geral Crianças Anesthesiology Marina Pandurov verfasserin aut Izabella Fabri Galambos verfasserin aut Goran Rakić verfasserin aut Vladimir Vrsajkov verfasserin aut Biljana Drašković verfasserin aut In Brazilian Journal of Anesthesiology Elsevier, 2018 70(2020), 2, Seite 97-103 (DE-627)DOAJ000117110 23522291 nnns volume:70 year:2020 number:2 pages:97-103 https://doi.org/10.1016/j.bjane.2020.02.007 kostenfrei https://doaj.org/article/6db44a471bd64da09cf194553592ce9c kostenfrei http://www.sciencedirect.com/science/article/pii/S0104001420300075 kostenfrei https://doaj.org/toc/0104-0014 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 70 2020 2 97-103 |
| allfields_unstemmed |
10.1016/j.bjane.2020.02.007 doi (DE-627)DOAJ084551380 (DE-599)DOAJ6db44a471bd64da09cf194553592ce9c DE-627 ger DE-627 rakwb eng RD78.3-87.3 Anna Uram Benka verfasserin aut Effects of caudal block in pediatric surgical patients: a randomized clinical trial 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. Bloqueio caudal Reposta ao estresse Anestesia geral Crianças Anesthesiology Marina Pandurov verfasserin aut Izabella Fabri Galambos verfasserin aut Goran Rakić verfasserin aut Vladimir Vrsajkov verfasserin aut Biljana Drašković verfasserin aut In Brazilian Journal of Anesthesiology Elsevier, 2018 70(2020), 2, Seite 97-103 (DE-627)DOAJ000117110 23522291 nnns volume:70 year:2020 number:2 pages:97-103 https://doi.org/10.1016/j.bjane.2020.02.007 kostenfrei https://doaj.org/article/6db44a471bd64da09cf194553592ce9c kostenfrei http://www.sciencedirect.com/science/article/pii/S0104001420300075 kostenfrei https://doaj.org/toc/0104-0014 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 70 2020 2 97-103 |
| allfieldsGer |
10.1016/j.bjane.2020.02.007 doi (DE-627)DOAJ084551380 (DE-599)DOAJ6db44a471bd64da09cf194553592ce9c DE-627 ger DE-627 rakwb eng RD78.3-87.3 Anna Uram Benka verfasserin aut Effects of caudal block in pediatric surgical patients: a randomized clinical trial 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. Bloqueio caudal Reposta ao estresse Anestesia geral Crianças Anesthesiology Marina Pandurov verfasserin aut Izabella Fabri Galambos verfasserin aut Goran Rakić verfasserin aut Vladimir Vrsajkov verfasserin aut Biljana Drašković verfasserin aut In Brazilian Journal of Anesthesiology Elsevier, 2018 70(2020), 2, Seite 97-103 (DE-627)DOAJ000117110 23522291 nnns volume:70 year:2020 number:2 pages:97-103 https://doi.org/10.1016/j.bjane.2020.02.007 kostenfrei https://doaj.org/article/6db44a471bd64da09cf194553592ce9c kostenfrei http://www.sciencedirect.com/science/article/pii/S0104001420300075 kostenfrei https://doaj.org/toc/0104-0014 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 70 2020 2 97-103 |
| allfieldsSound |
10.1016/j.bjane.2020.02.007 doi (DE-627)DOAJ084551380 (DE-599)DOAJ6db44a471bd64da09cf194553592ce9c DE-627 ger DE-627 rakwb eng RD78.3-87.3 Anna Uram Benka verfasserin aut Effects of caudal block in pediatric surgical patients: a randomized clinical trial 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. Bloqueio caudal Reposta ao estresse Anestesia geral Crianças Anesthesiology Marina Pandurov verfasserin aut Izabella Fabri Galambos verfasserin aut Goran Rakić verfasserin aut Vladimir Vrsajkov verfasserin aut Biljana Drašković verfasserin aut In Brazilian Journal of Anesthesiology Elsevier, 2018 70(2020), 2, Seite 97-103 (DE-627)DOAJ000117110 23522291 nnns volume:70 year:2020 number:2 pages:97-103 https://doi.org/10.1016/j.bjane.2020.02.007 kostenfrei https://doaj.org/article/6db44a471bd64da09cf194553592ce9c kostenfrei http://www.sciencedirect.com/science/article/pii/S0104001420300075 kostenfrei https://doaj.org/toc/0104-0014 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 70 2020 2 97-103 |
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Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Bloqueio caudal</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Reposta ao estresse</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Anestesia geral</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Crianças</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Anesthesiology</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Marina Pandurov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Izabella Fabri Galambos</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Goran Rakić</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Vladimir Vrsajkov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Biljana Drašković</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Brazilian Journal of Anesthesiology</subfield><subfield code="d">Elsevier, 2018</subfield><subfield code="g">70(2020), 2, Seite 97-103</subfield><subfield code="w">(DE-627)DOAJ000117110</subfield><subfield code="x">23522291</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:70</subfield><subfield code="g">year:2020</subfield><subfield code="g">number:2</subfield><subfield code="g">pages:97-103</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.1016/j.bjane.2020.02.007</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/6db44a471bd64da09cf194553592ce9c</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">http://www.sciencedirect.com/science/article/pii/S0104001420300075</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/0104-0014</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">70</subfield><subfield code="j">2020</subfield><subfield code="e">2</subfield><subfield code="h">97-103</subfield></datafield></record></collection>
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effects of caudal block in pediatric surgical patients: a randomized clinical trial |
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Effects of caudal block in pediatric surgical patients: a randomized clinical trial |
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Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. |
| abstractGer |
Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. |
| abstract_unstemmed |
Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. One group (n = 30) received general anesthesia and the other (n = 30) received general anesthesia with a caudal block. Hemodynamic parameters, drug consumption and pain intensity were measured. Blood samples for serum glucose and cortisol level were taken before anesthesia induction and after awakening the patient. Results: Children who received a caudal block had significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01) and pain scores 3 h (p = 0.002) and 6 h (p = 0.003) after the operation, greater hemodynamic stability and lower drug consumption. Also, there were no side effects or complications identified in that group. Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas. |
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Conclusions: The combination of caudal block with general anesthesia is a safe method that leads to less stress, greater hemodynamic stability, lower pain scores and lower consumption of medication. Resumo: Justificativa: O estresse cirúrgico causa resposta neuroendócrina, resultando em instabilidade hemodinâmica indesejável, modificações na resposta metabólica e disfunção no sistema imune. Objetivos: O objetivo deste estudo foi avaliar em pacientes pediátricos a eficácia do bloqueio peridural caudal no controle da dor intra e pós-operatória e na redução da resposta ao estresse nesses períodos. Métodos: Estudo clínico prospectivo randomizado que incluiu 60 pacientes submetidos à herniorrafia eletiva. Um grupo (n = 30) recebeu anestesia geral, e o outro (n = 30) anestesia geral combinada a bloqueio caudal. Foram medidos os parâmetros hemodinâmicos, o consumo de drogas e a intensidade da dor. Amostras de sangue para medir glicemia e cortisol plasmático foram obtidas antes da indução e após o despertar dos pacientes. Resultados: As crianças que receberam bloqueio peridural caudal apresentaram valores significantemente mais baixos para glicemia (p < 0,01), concentração de cortisol (p < 0,01) e escores de dor de 3 horas (p = 0,002 e 6 horas p = 0,003 após a cirurgia, maior estabilidade hemodinâmica e menor consumo de drogas. Além disso, não foram observados efeitos colaterais ou complicações neste grupo. Conclusões: O bloqueio peridural caudal combinado à anestesia geral é uma técnica segura e que se associa o menor estresse, maior estabilidade hemodinâmica, redução nos escores de dor e baixo consumo de drogas.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Bloqueio caudal</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Reposta ao estresse</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Anestesia geral</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Crianças</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Anesthesiology</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Marina Pandurov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Izabella Fabri Galambos</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Goran Rakić</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Vladimir Vrsajkov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Biljana Drašković</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Brazilian Journal of Anesthesiology</subfield><subfield code="d">Elsevier, 2018</subfield><subfield code="g">70(2020), 2, Seite 97-103</subfield><subfield code="w">(DE-627)DOAJ000117110</subfield><subfield code="x">23522291</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:70</subfield><subfield code="g">year:2020</subfield><subfield code="g">number:2</subfield><subfield code="g">pages:97-103</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.1016/j.bjane.2020.02.007</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/6db44a471bd64da09cf194553592ce9c</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">http://www.sciencedirect.com/science/article/pii/S0104001420300075</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/0104-0014</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">70</subfield><subfield code="j">2020</subfield><subfield code="e">2</subfield><subfield code="h">97-103</subfield></datafield></record></collection>
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