The effects of caudal block application on the level of peroperative anaesthetic agent and postoperative analgesia in the children [COCUKLARDA KAUDAL BLOK UYGULAMASININ PEROPERATIF ANESTEZIK AJAN DUZEYI VE POSTOPERATIF ANALJEZI UZERINE ETKILERI]

In this study, we aimed to research the effect of caudal anaesthesia on the saving of peroperative anaesthetic agent and the postoperative pain relief in pediatric patient. Ninety male pediatric patients, age 1 to 10, were operated on inguinal hernia, orchiopexy and hydrochelectomy, included to our study. All the patients were divided into three groups. The induction of anaesthesia was obtained with N2O 67 %, O2 33 % and halothane 3 %. In group 1 (n=50), caudal blockage with bupivacaine 0.25 % (0.5 mL/kg) was applied after the anaesthesia induction. In group 2 (n=20), caudal blockage with bupivacaine 0.25 % (0.5 mL/kg) was applied before turning of anaesthesia. In group 3 (n=20), meperidine (1 mg/kg) was administered at the end of operation, intravenously. The sufficient depth of anaesthesia was evaluated depending on surgical stimulation without moving, sweating, tearing and no increases 10 % of heart rate, systolic and diastolic blood pressure. The required concentration of halothane and neuromuscular blocker agent, the time of spontaneous eye opening were determined. Using Quecher's and objective pain scales the pain was evaluated after awakening and at 1st, 2nd, 3rd and 4th hours postoperatively. The sufficient concentration of halothane was observed to be lower in group 1 than in groups 2 and 3 at 15 minutes following anaesthesia induction. There were no differences analgesia levels in groups 1 and 2, whereas the scales of pain was determined to be lower in groups 1 and 2 than in group 3 after awakening and 1st, 2nd, 3rd, 4th hours postoperatively. In conclusion, we considered that caudal anaesthesia decreased the peroperative anaesthetic agent requirement and the timing of caudal anaesthesia had no effect on the duration of postoperative analgesia, and was more preferable than the intravenous meperidine application.