Nasibova EM, Poluxov R.Sh, Ismailov IS. Our Experience of using Caudal Anesthesia in "Small" Surgical Interventions in Newborns. Int J Anesth Res. 2018;6(8):543-544.
543
OPEN ACCESS https://scidoc.org/IJAR.php
International Journal of Anesthesiology & Research (IJAR)
ISSN 2332-2780
*Corresponding Author:
Nasibova Esmira Mirza gizi,
Associate Professor, Department of Pediatric Surgery, Azerbaijan Medical University, Azerbaijan.
Tel: +9940503366077
E-mail: doc.nasibova.esmira@gmail.com
Received: October 28, 2018
Accepted: November 22, 2018
Published: November 23, 2018
Citation: Nasibova EM, Polukhov R. Sh, Ismailov IS. Our Experience of using Caudal Anesthesia in "Small" Surgical Interventions in Newborns. Int J Anesth Res. 2018;6(8):543-544.
doi: http://dx.doi.org/10.19070/2332-2780-18000109
Copyright: Nasibova EM
©
2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution
and reproduction in any medium, provided the original author and source are credited.
Introduction
It has now been proven that caudal anesthesia is the safest and
most effective way of anesthesia. To date, caudal anesthesia is the
most commonly used technique for regional blockades in new-
borns. It is used alone or in combination with general anesthesia
[1-4]. The advantages of the method include reliability (analge-
sia with an effective caudal block is provided in 98% of cases),
safety (puncture of caudal space in children is the easiest access
to the epidural space and, when properly performed, the danger
of damage to the spinal cord and dura mater is extremely small)
simplicity (easily perceived and mastered by trainees) [5-8]. Indi-
cations for caudal anesthesia are surgical interventions below the
level of the navel (Th10).
Material and Methods of Research
The work was carried out in the surgical clinic AMU. The study in-
cluded 117 newborns operated on a one-sided or bilateral inguinal
hernia, phimosis, paraphimosis and rectal atresia. The duration of
operations was from 30 minutes to 1.5 hours. Induction of anes-
thesia was carried out by intravenous administration of propofol
at a rate of 3 mg/kg. After the patient completely fell asleep, the
caudal block was performed. The puncture of the caudal space
was performed in the position of the patient on the left side with
the lower extremities bent at an angle of 90° in the hip and knee
joints. After puncturing the sacrococcygeal ligament at an angle
of 60◦ to the skin, changing the angle of introduction by 45°
advanced the needle into the sacral canal. Further, the presence
or absence of blood, or cerebrospinal fuid in the pavilion of the
Our Experience of using Caudal Anesthesia in "Small" Surgical Interventions in Newborns
Research Article
Nasibova EM
1*
, Polukhov R. Sh
1
, Ismailov IS
2
1
Associate Professor of the Department of Pediatric Surgery, Azerbaijan Medical University, Azerbaijan.
2
Professor, Department of Rheumatology and Internal Diseases, Azerbaijan.
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 atre-
sia. 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. Through-
out the period of the surgical intervention (duration averaged from 30 minutes to 1.5 hours), the central hemodynamics index
was stable, while the fuctuations of the studied parameters were insignifcant 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 signifcant changes in
hemodynamic parameters of the entire period of effective analgesia.