Comparison of hemodynamic response and postoperative pain score between general anaesthesia with intravenous analgesia versus general anesthesia with caudal analgesia in pediatric patients undergoing open-heart surgery

Autor: Vivek Chowdhry, Dharma Jivan Samantaray, Satish Reedy, Meena Trehan
Rok vydání: 2019
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Hemodynamics
Context (language use)
030204 cardiovascular system & hematology
Anesthesia
General
law.invention
lcsh:RD78.3-87.3
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
030202 anesthesiology
law
medicine
Humans
General anaesthesia
Prospective Studies
Cardiac Surgical Procedures
Prospective cohort study
Child
Infusions
Intravenous
Analgesics
Pain
Postoperative
business.industry
Infant
General Medicine
caudal epidural
Surgery
Cardiac surgery
Buprenorphine
Analgesia
Epidural
Anesthesiology and Pain Medicine
Blood pressure
pediatric open-heart surgery
lcsh:Anesthesiology
lcsh:RC666-701
Cardiothoracic surgery
Anesthesia
Child
Preschool
Female
Original Article
Cardiology and Cardiovascular Medicine
business
Zdroj: Annals of Cardiac Anaesthesia
Annals of Cardiac Anaesthesia, Vol 22, Iss 1, Pp 35-40 (2019)
ISSN: 0974-5181
Popis: Context: Regional anesthesia may attenuate adverse physiological stress responses associated with cardiothoracic surgery. In this study, hemodynamic stress response at the different time of surgical stimuli was compared between patients receiving general anesthesia (GA) along with caudal epidural analgesia with GA with intravenous analgesia in pediatric population undergoing open-heart surgery. Aims: This study aims to compare the hemodynamic response at the different time of surgical stimuli and postoperative pain score, in pediatric patients undergoing open-heart procedures. Settings and Design: We designed a prospective randomized controlled trial to study hemodynamic effects between Group I and Group II. Fifty patients were randomly allocated equally into Group I (GA + caudal epidural) and Group II (GA + intravenous analgesia) by sealed envelope technique. Subjects and Methods: After obtaining approval from Institutional Ethical Committee, this prospective study was conducted in 50 American Society of Anesthesiologist Classes II and III pediatric patients aged between 1 and 12 years posted for cardiac surgery in our institution. Statistical Analysis: ANOVA, two-way ANOVA, and Student's test. Results: The heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure variations were compared between Groups I and II at different time intervals. The variations were found to be significantly higher at the time of skin incision and 2 min after skin incision in Group II as compared to Group I. Pain score was compared between the groups and was found to be significantly lower with Group I (2.5 ± 1.2) as compared to Group II (4.6 ± 1.7), P = (0.004). Conclusions: Caudal analgesia with GA (Group I) was found to have better hemodynamic control and significantly better postoperative pain relief in the first 24 h after awakening.
Databáze: OpenAIRE
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