Hemodynamic Effects of Caudal Blocks in Different Age Group of Children: A Prospective Observational Pilot Study using USCOM
Paradee Siriboon MD*, Pichaya Waitayawinyu MD*, Suwannee Suraseranivongse MD, MSc*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To compare changes in hemodynamic parameters including systemic vascular resistance (SVR), cardiac output
(CO), blood pressure (BP) and heart rate (HR) after caudal block in different age groups of children.
Material and Method: This single-center observational pilot study was conducted in ASA 1 to 2 children, less than 8 years
of age who underwent surgeries under combined GA and caudal block from December 2013 to December 2014. Patients
were divided into 3 groups (Group 1 = 0 to 1 years old, Group 2 = 1 to 3 years old, Group 3 = 3 to 8 years old). Hemodynamic
parameters were measured with USCOM and compared at baseline and at 5, 10, and 15 minutes after caudal block with 1
mL/kg 0.25% bupivacaine.
Results : Total of 42 participants enrolled in this study (Group 1 = 11, Group 2 = 15, Group 3 = 16). CO, mean arterial blood
pressure (MAP), and HR decreased after caudal block. HR and CO reductions were more pronounced in Group 3. MAP
reduction was highest in Group 2. There was no reduction in SVR after caudal block in all groups.
Conclusion : No evidence of SVR reduction after caudal block in children less than 8 years old, which reflects immature
sympathetic nervous system of this patient group. There were reductions in CO, MAP, and HR in these patients, especially in
3 to 8 years old. Future study with more participants is required to make conclusion.
Keywords : Caudal block, Pediatrics, Hemodynamic changes, USCOM
