Ali Ahiskalioglu1, Ahmet Murat Yayik2, Elif Oral Ahiskalioglu2, Mursel Ekinci3, Birzat Emre Gölboyu4, Erkan Cem Celik2, Haci Ahmet Alici5, Akgun Oral6, Saban Oguz Demirdogen7. 1. Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey. Electronic address: aliahiskalioglu@hotmail.com. 2. Department of Anesthesiology, Regional Training and Research Hospital, Erzurum, Turkey. 3. Department of Anesthesiology, Medipol University, Istanbul, Turkey. 4. Department of Anesthesiology, Suleyman Demirel, Isparta, Turkey. 5. Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey. 6. Department of Pediatric Surgery, Ataturk University School of Medicine, Erzurum, Turkey. 7. Department of Urology, Ataturk University School of Medicine, Erzurum, Turkey.
Abstract
STUDY OBJECTIVE: The aim of this study was to compare the efficacies of ultrasound guided sacral hiatus injection and conventional sacral canal injection performed for caudal block in children. DESIGN: Randomized controlled clinical trial. SETTING:Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: One hundred-thirty four children, American Society of Anesthesiologists I-II, between the ages of 5 and 12, scheduled for elective phimosis and circumcision surgery. INTERVENTIONS: Patients assigned to two groups for ultrasound guided caudal block (Group U, n=68) or conventional caudal block (Group C, n=66). Caudal solution was prepared as 0.125% levobupivacaine plus 10mcg/kg morphine (total volume: 0.5ml/kg), and was administered to both groups. MEASUREMENTS: The block performing time, the block success rate, the number of needle puncture, the success at first puncture and the complications were recorded. MAIN RESULTS: The block performing time and the success rate of block were similar between Group U and Group C (109.96±49.73s vs 103.17±45.12s, and 97% vs 93%, respectively p>0.05). The first puncture success rate was higher in Group U than in Group C (80% vs 63%, respectively p=0.026). No significant difference was observed between the groups with regard to the number of needle punctures (p=0.060). The rates of vascular puncture and subcutaneus bulging were higher in Group C than in Group U (8/66 vs 1/68, and 8/66 vs 0/68, respectively p<0.05). CONCLUSIONS: Despite the limitations in central neuroaxial anesthesia we recommend the use of ultrasound since it reduces the complications and increases the success rate of first puncture in pediatric caudal injection.
RCT Entities:
STUDY OBJECTIVE: The aim of this study was to compare the efficacies of ultrasound guided sacral hiatus injection and conventional sacral canal injection performed for caudal block in children. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: One hundred-thirty four children, American Society of Anesthesiologists I-II, between the ages of 5 and 12, scheduled for elective phimosis and circumcision surgery. INTERVENTIONS:Patients assigned to two groups for ultrasound guided caudal block (Group U, n=68) or conventional caudal block (Group C, n=66). Caudal solution was prepared as 0.125% levobupivacaine plus 10mcg/kg morphine (total volume: 0.5ml/kg), and was administered to both groups. MEASUREMENTS: The block performing time, the block success rate, the number of needle puncture, the success at first puncture and the complications were recorded. MAIN RESULTS: The block performing time and the success rate of block were similar between Group U and Group C (109.96±49.73s vs 103.17±45.12s, and 97% vs 93%, respectively p>0.05). The first puncture success rate was higher in Group U than in Group C (80% vs 63%, respectively p=0.026). No significant difference was observed between the groups with regard to the number of needle punctures (p=0.060). The rates of vascular puncture and subcutaneus bulging were higher in Group C than in Group U (8/66 vs 1/68, and 8/66 vs 0/68, respectively p<0.05). CONCLUSIONS: Despite the limitations in central neuroaxial anesthesia we recommend the use of ultrasound since it reduces the complications and increases the success rate of first puncture in pediatric caudal injection.