Document Detail


The hemodynamic effects of newborn caudal anesthesia assessed by transthoracic echocardiography: a randomized, double-blind, controlled study.
MedLine Citation:
PMID:  18950332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Caudal anesthesia has been increasingly used in abdominal, urinary tract, and lower extremity surgery of infants. However, little was known about the hemodynamic effects of caudal anesthesia in them, especially in neonates. The purpose of this prospective study was designed to investigate the hemodynamic alterations by transthoracic echocardiography in newborn baby after caudal anesthesia with plain Bupivacaine or with epinephrine added Bupivacaine. METHODS: Thirty full-term newborn infants scheduled for lower abdominal or urinary tract surgery were randomly allocated into three groups (n = 10 each) as follows: (i) GA group: general anesthesia with sevoflurane; (ii) GA+CP group: GA with sevoflurane, combined with caudal anesthesia of plain Bupivacaine (1.25 ml x kg(-1) of 0.2%); (iii) GA+CA group: sevoflurane GA combined with caudal anesthesia of epinephrine-added Bupivacaine (1.25 ml x kg(-1) of 0.2% Bupivacaine plus 1/200,000 epinephrine). Cardiac output (CO), arterial blood pressure, and heart rate were measured before (T-5) and 5(T5), 10(T10), 15(T15) min after performance of caudal anesthesia. RESULTS: In GA group, no significant hemodynamic alteration was observed in comparison with T-5, except HR, which decreased by 7% at T15; In GA+CP group, compared with T-5, HR decreased significantly at T5, T10 and T15, respectively, by 6%, 7% and 10%. And also CO decreased significantly at T15 by 8% compared with T-5; In GA+CA group, no significant hemodynamic alteration was observed expect diastolic arterial blood, which decreased significantly at T15 by 10% compared with T-5; At T15, the larger decrease of systolic arterial blood in GA+CP group and GA+CA group vs (GA) group (P < 0.05). CONCLUSIONS: The study shows the stability of hemodynamic variables during caudal anesthesia with Bupivacaine and with epinephrine-added Bupivacaine in newborn infants.
Authors:
Meng Deng; Xuan Wang; Lihong Wang; Shan Zheng
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  18     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-27     Completed Date:  2009-01-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  1075-81     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China. dengmeng05@163.com
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Caudal / methods*
Anesthetics, Local / pharmacology*
Bupivacaine / pharmacology*
Double-Blind Method
Echocardiography*
Epinephrine / pharmacology
Hemodynamics / drug effects*
Humans
Infant, Newborn
Prospective Studies
Treatment Outcome
Vasoconstrictor Agents / pharmacology
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 0/Vasoconstrictor Agents; 2180-92-9/Bupivacaine; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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