The Effects of Caudal Block on Emergence Agitation after Sevoflurane Anesthesia in Herniorrhaphy Pediatric Patients

An, Tae Hun

Abstract

BACKGROUND
Children usually exhibit pain-related behavior in postanesthetic care units. The aim of the present study was to assess the recovery quality of herniorrhaphy pediatric patients who received sevoflurane with or without caudal block.
METHODS
Thirty children, ASA 1, scheduled for herniorrhaphy were randomly assigned to receive either a caudal block (n = 15) or no caudal block (n = 15). All children were premedicated with midazolam (0.05 mg/kg) and glycopyrrolate (0.004 mg/kg) an hour before anesthesia induction. Thiopental sodium (5 mg/kg) and the inhalation of sevoflurane 2 vol% in N2O/O2 50/50 via a mask, were used to induce anesthesia. After induction, group 1 did not receive caudal block, whereas group 2 did. Rocuronium (0.6 mg/kg) was used for the tracheal intubation. Anesthesia was maintained by the inhalation of sevoflurane via an endotracheal tube. Recovery was assessed by an independent observer using a postanesthetic recovery score. Pain scores were also obtained by an independent observer using a pain/discomfort scale. Recovery and agitation characteristics of the two groups were compared on emergence.
RESULTS
The groups were similar with respect to age, weight, duration of inhalation exposure, and recovery score. Agitation and pain scores were lower in the caudal group (P < 0.01). Emergence agitation occured less frequently in the caudal group (P < 0.01).
CONCLUSIONS
Emergence agitation after sevoflurane anesthesia was less common in caudal group. Thus, we believe that the analgesic action of caudal block reduces emergence agitation during recovery from sevoflurane anesthesia.