Öz
Objective: In 2013 in our hospital from January to May, between 27 patients who underwent urological surgery circumcision performed after induction of general anesthesia, caudal block, intraoperative, and postoperative complications were retrospectively to evaluate the analgesic efficacy. Materials and methods: In this study of 2013 January-May circumcision operation between the months of pediatric urological surgery and caudal block was evaluated retrospectively applied to a study of 27 cases files. Cases, files, forms, and nurse anesthesia, follow-up observation forms is examined and the demographic data, anesthetic agent used for induction and maintenance of anesthesia, duration of surgery, type of local anesthetic is applied to the caudal block, concentration, volume, intraoperative and postoperative analgesic requirements were recorded with the administration, time and complications views . Results: Mean age was 4.9 ± 2.92 years of age range 1-14 years and the average body weight of 19.55 ± 6.51 kg, respectively. Caudal block, 0.20% bupivacaine 0.8 ml / kg in patients undergoing anesthesia, duration of surgery was 34.62 ± 4.61 minutes duration has been saved. The intraoperative and postoperative analgesia in any analgesic yet the average length of 20.74 ± 7.25 hours, respectively. Reported no complications in the postoperative period. Conclusion: Caudal block in pediatric inguinal surgery, urogenital, rectal, intraoperative and postoperative analgesia for operations in the region and to provide an effective method of reducing complications
Anahtar Kelimeler
Kaynakça
- Silvani P, Camporesi A, Agostino MR, Salvo I. Caudal anesthesia in pediatrics: an update. Minerva Anestesiol 2006; 72: (6) 453 - 9.
- Zadra N, Giusti F. Caudal block in pediatrics. Minerva Anestesiol 2006; 67: (9) 126 - 31.
- Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85: (1) 109 - 17.
- Sendasgupta C, Makhija N, Kiran U, Choudhary SK, Lakshmy R, Das SN. Caudal epidural sufentanil and bupivacaine decreases stress response in paediatric cardiac surgery. Ann Card Anaesth 2009; 12: (1) 27 - 33.
- Mazoit JX, Decaux A, Bouaziz H, Edouard A. Comparative ventricular electrophysiologic effect of racemic bupivacaine, levobupivacaine, and ropivacaine on the isolated rabbit heart. Anesthesiology 2000; 93: (3) 784 - 92.
- Morrison SG, Dominguez JJ, Frascarolo P, Reiz S. A comparison of the electrocardiographic cardiotoxic effects of racemic bupivacaine, levobupivacaine, and ropivacaine in anesthetized swine. Anesth Analg 2000; 90: (6) 1308 - 14.
- Breschan C, Jost R, Krumphuolz R, Schaumberger F, Sttetner H, Marhofer P, et al. A prospective study comparing the analgesic efficacy of levobupivacaine, ropivacaine and bupivacaine in pediatric patient undergoing caudal blockade. PediatrAnaesth 2005; 15: (4) 301 - 06.
- Frawley GP, Downie S, Huang GH. Levobupivacaine caudal anesthesia in children a randomized double blind comparison with bupivacaine. Pediatr Anaesth 2006; 16: (7) 754 - 60.
- Kayhan Z. Clinical Anaesthesia, Logos Corp. May 2004. (3). edition page 694 - 95
- Johnston P, Findlow D, Aldridge LM, Doyle E. The effect of ketamine on 0.25% and 0.125% bupivacaine for caudal epidural blockade in children. Pediatr Anaesth 1999; 9: (1) 31
- Gunter JB, Dunn CM, Bennie JB, Pentecost DL, Bower RJ, Ternberg JL. Optimum concentration of bupivacaine for combined Anesthesiology 1991; 75: (1) 57 - 61
- Gunter J. Caudal anesthesia in children: A survey. Anesthesiology 1991; 75: A936
- Veyckemans F, Van Obbergh LJ, Gouverneur JM. Lessons from 1100 pediatric caudal blocks in a teaching hospital. Reg Anesth 1992; 17: (3) 119 - 25.
- Prosser DP, Davis A, Brooker PD, et al. Caudal tramadol for postoperative analgesia in pediatric hypospadias surgery. Br J Anaesth 1997; 79: (3) 293 – 6
- De Mey JC, Brusselmans G, Rolly G. Postoperative analgesia following surgical correction of hypospadias. Ann Urol 1996; 30: (4) 192 – 6
- Yücel A. Evaluation of Patients Having Pain In: Yücel A (ed) Patient-controlled Anaesthesia 1st ed. İstanbul: MER Publishing, 197: 25 – 30 Malviya S, Fear D, Roy WL, Lerman J. Adequacy of caudal analgesia in children after penoscrotal and inguinal surgery using 0.5 or 1 ml/kg bupivacaine 0.125 % Can J Anaesth 1992; 39: (5) 449 – 53
- Klimscha W, Chiari A, Lerche A, Michalek-Sauberer A, Wildling clonidine/bupivacaine combination in caudal blockade for pediatric henia repair. Anesth Analg 1998; 86: (1) 54 – 61 a
- Girotra S, Kumar S, Rajendran KM. Postoperative analgesia in children who have genitourinary surgery. A comparasion between caudal buprenorpfine and bupivacaine. Anaesthesia 1990; 45: (5) 406 – 8
- Esener Z. [Pediatric Anaesthesia. In: Esener Z (ed). Clinical Anaesthesia. 1st ed.. Samsun: Logos Corp., 1991: 473 – 97]
- Özcengiz D, Özbek H. Regional Anaesthesia. In: Özcengiz D, Özbek H (eds). Anaesthesia Hand Book 1st ed.. Adana: Nobel Publishing, 1998: 393 – 07
- Sanders JC. Paediatric regional anaesthesia, a survey of practice in the United kingdom. Br J Anaesth 2002; 89; (5) 707 – 10
- Schrock CR, Barry J. The dose of caudal epidural analgesia andduration of postoperative analgesia Pediatr Anaesth 2003; 13: (5) 403 – 8
- Verghese ST, Hannallah ST, Rice LJ, BelmanAB, Patel KM. Caudal anaesthesia in children: effecte of volume vs concentration of bupivacaine on blockingspermetic cord traction response during orchidopexy. Anesth Analg 2002; 95: 1219 – 23
- Busoni P, Andreuccetti T. The spread of caudal analgesia in children: a mathematical model. Anesth Intensive Care 1986; 14: (2) 140 – 44
- De Beer DA, Thomas ML. Caudal additives in children – solutions or problems? Br J Anaesth 2003; 90: (4) 487 – 98
- Gezer E, Uğur B, Sen S, Oğurlu M, Aydın MN, Gürsoy F. Retrospective evaluation of caudal anaesthesia in pediatric surgery. ADÜ Faculty of Medicine Journal 2006; 7: (2) 27 – 30
- Erol U, Dodu D. Hemodynamic effects of caudal anaesthesia in addition to general anaesthesia in children. T Clin J Med Sci 1997, 17: 32 – 5
- Tuğcu V, Yetkin M, Karadağ S, Emir N.S, Özbek E, Taşcı A. İ. Caudal blocking in hypospadias surgery. Turkish Urology Journal: 2005, 31 (2): 220 – 4
Öz
Amaç: Hastanemizde 2013 yılı Ocak – Mayıs ayları arasında, ürolojik cerrahide sünnet operasyonu geçirmiş 27 olguda genel anestezi indüksiyonu sonrasında yapılan kaudal bloğun, intraoperatif, postoperatif dönemde analjezik etkinliğini ve komplikasyonlarını retrospektif olarak değerlendirmeyi amaçladık.
Gereç ve yöntem: Bu çalışmada 2013 yılı Ocak – Mayıs ayları arasındaki pediyatrik ürolojik cerrahide sünnet operasyonu geçiren ve kaudal blok uygulanan 27 vakanın dosyalarının retrospektif olarak değerlendirildiği bir çalışmadır. Olguların dosyaları, anestezi izlem formları ve hemşire gözlem formları incelenerek; olguların demografik verileri, anestezi indüksiyonu ve idamesinde kullanılan anestezik ajan, cerrahi süre, kaudal blokta uygulanan lokal anestezik türü, konsantrasyonu, volümü, intraoperatif ve postoperatif analjezik ihtiyacı ile verilme zamanları ve kaydedilen komplikasyonlara bakıldı.
Bulgular: Yaş ortalamaları 4,9±2,92 yıl, yaş aralığı 1 – 14 yaş olup vücut ağırlıkları ortalama 19,55±6,51 kg olarak bulundu. Kaudal blokta %0.20’lik konsantrasyonda 0,8 ml/kg volümde bupivakain uygulanan hastaların cerrahi süre 34,62±4,61 dakika iken anestezi süreleri kaydedilmedi. İntraoperatif dönemde herhangi bir analjezik yapılmadı ve postoperatif analjezi süreleri ortalama 20,74±7,25 saat olarak saptandı. Postoperatif dönemde hastaların hiç birinde herhangi bir komplikasyon saptanmadı.
Sonuç: Kaudal blok pediyatrik cerrahide inguinal, ürogenital, rektal bölgede yapılan operasyonlarda intraoperatif ve postoperatif dönemde analjezi sağlamada ve komplikasyonların azaltılmasında etkili bir yöntemdir.
Anahtar Kelimeler
Kaynakça
- Silvani P, Camporesi A, Agostino MR, Salvo I. Caudal anesthesia in pediatrics: an update. Minerva Anestesiol 2006; 72: (6) 453 - 9.
- Zadra N, Giusti F. Caudal block in pediatrics. Minerva Anestesiol 2006; 67: (9) 126 - 31.
- Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85: (1) 109 - 17.
- Sendasgupta C, Makhija N, Kiran U, Choudhary SK, Lakshmy R, Das SN. Caudal epidural sufentanil and bupivacaine decreases stress response in paediatric cardiac surgery. Ann Card Anaesth 2009; 12: (1) 27 - 33.
- Mazoit JX, Decaux A, Bouaziz H, Edouard A. Comparative ventricular electrophysiologic effect of racemic bupivacaine, levobupivacaine, and ropivacaine on the isolated rabbit heart. Anesthesiology 2000; 93: (3) 784 - 92.
- Morrison SG, Dominguez JJ, Frascarolo P, Reiz S. A comparison of the electrocardiographic cardiotoxic effects of racemic bupivacaine, levobupivacaine, and ropivacaine in anesthetized swine. Anesth Analg 2000; 90: (6) 1308 - 14.
- Breschan C, Jost R, Krumphuolz R, Schaumberger F, Sttetner H, Marhofer P, et al. A prospective study comparing the analgesic efficacy of levobupivacaine, ropivacaine and bupivacaine in pediatric patient undergoing caudal blockade. PediatrAnaesth 2005; 15: (4) 301 - 06.
- Frawley GP, Downie S, Huang GH. Levobupivacaine caudal anesthesia in children a randomized double blind comparison with bupivacaine. Pediatr Anaesth 2006; 16: (7) 754 - 60.
- Kayhan Z. Clinical Anaesthesia, Logos Corp. May 2004. (3). edition page 694 - 95
- Johnston P, Findlow D, Aldridge LM, Doyle E. The effect of ketamine on 0.25% and 0.125% bupivacaine for caudal epidural blockade in children. Pediatr Anaesth 1999; 9: (1) 31
- Gunter JB, Dunn CM, Bennie JB, Pentecost DL, Bower RJ, Ternberg JL. Optimum concentration of bupivacaine for combined Anesthesiology 1991; 75: (1) 57 - 61
- Gunter J. Caudal anesthesia in children: A survey. Anesthesiology 1991; 75: A936
- Veyckemans F, Van Obbergh LJ, Gouverneur JM. Lessons from 1100 pediatric caudal blocks in a teaching hospital. Reg Anesth 1992; 17: (3) 119 - 25.
- Prosser DP, Davis A, Brooker PD, et al. Caudal tramadol for postoperative analgesia in pediatric hypospadias surgery. Br J Anaesth 1997; 79: (3) 293 – 6
- De Mey JC, Brusselmans G, Rolly G. Postoperative analgesia following surgical correction of hypospadias. Ann Urol 1996; 30: (4) 192 – 6
- Yücel A. Evaluation of Patients Having Pain In: Yücel A (ed) Patient-controlled Anaesthesia 1st ed. İstanbul: MER Publishing, 197: 25 – 30 Malviya S, Fear D, Roy WL, Lerman J. Adequacy of caudal analgesia in children after penoscrotal and inguinal surgery using 0.5 or 1 ml/kg bupivacaine 0.125 % Can J Anaesth 1992; 39: (5) 449 – 53
- Klimscha W, Chiari A, Lerche A, Michalek-Sauberer A, Wildling clonidine/bupivacaine combination in caudal blockade for pediatric henia repair. Anesth Analg 1998; 86: (1) 54 – 61 a
- Girotra S, Kumar S, Rajendran KM. Postoperative analgesia in children who have genitourinary surgery. A comparasion between caudal buprenorpfine and bupivacaine. Anaesthesia 1990; 45: (5) 406 – 8
- Esener Z. [Pediatric Anaesthesia. In: Esener Z (ed). Clinical Anaesthesia. 1st ed.. Samsun: Logos Corp., 1991: 473 – 97]
- Özcengiz D, Özbek H. Regional Anaesthesia. In: Özcengiz D, Özbek H (eds). Anaesthesia Hand Book 1st ed.. Adana: Nobel Publishing, 1998: 393 – 07
- Sanders JC. Paediatric regional anaesthesia, a survey of practice in the United kingdom. Br J Anaesth 2002; 89; (5) 707 – 10
- Schrock CR, Barry J. The dose of caudal epidural analgesia andduration of postoperative analgesia Pediatr Anaesth 2003; 13: (5) 403 – 8
- Verghese ST, Hannallah ST, Rice LJ, BelmanAB, Patel KM. Caudal anaesthesia in children: effecte of volume vs concentration of bupivacaine on blockingspermetic cord traction response during orchidopexy. Anesth Analg 2002; 95: 1219 – 23
- Busoni P, Andreuccetti T. The spread of caudal analgesia in children: a mathematical model. Anesth Intensive Care 1986; 14: (2) 140 – 44
- De Beer DA, Thomas ML. Caudal additives in children – solutions or problems? Br J Anaesth 2003; 90: (4) 487 – 98
- Gezer E, Uğur B, Sen S, Oğurlu M, Aydın MN, Gürsoy F. Retrospective evaluation of caudal anaesthesia in pediatric surgery. ADÜ Faculty of Medicine Journal 2006; 7: (2) 27 – 30
- Erol U, Dodu D. Hemodynamic effects of caudal anaesthesia in addition to general anaesthesia in children. T Clin J Med Sci 1997, 17: 32 – 5
- Tuğcu V, Yetkin M, Karadağ S, Emir N.S, Özbek E, Taşcı A. İ. Caudal blocking in hypospadias surgery. Turkish Urology Journal: 2005, 31 (2): 220 – 4
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Orjinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Mart 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 5 Sayı: 1 |