The Hemodynamic Effects of Different Volumes of Bupivacaine 0.25% Caudal Blocks in Pediatrics Undergoing Lower Abdominal Surgeries as Measured by Electrical Cardiometry: A Randomized Controlled Study

Introduction:

Caudal block is one of the most used regional blocks in pediatrics because it is safe and provides efficient and adequate perioperative analgesia for most of the infra-umbilical and lower limb procedures.[1,2] It has been proposed that the cardiovascular effects of neuraxial blocks are less marked in children than in adults because of lower systemic vascular resistance (SVR) in pediatric population.[3] There is a wide range of doses used in caudal block depending on the desired dermatomal level which can range from 0.5ml/kg up to 1.25ml/kg. [1] However, studies assessing effects and safety of different volumes of caudal blocks on different hemodynamic variables are scarce and show conflicting results due to small sample sizes, absence of control groups, retrospective nature, different additives and different methods for measuring the hemodynamics.[4-8] Electrical Cardiometry (EC) estimates cardiac parameters by measuring changes in thoracic electrical bioimpedance during the cardiac cycle using skin electrodes. It has emerged as a new noninvasive tool for assessment of cardiac output with a good accuracy in adult and pediatric anesthesia.[9] The current study is designed to estimate the effects of different volumes of bupivacaine 0.25% caudal block on different hemodynamic parameters assessed by electrical cardiometry.

Hypothesis:

We hypothesized that different volumes of plain bupivacaine 0.25% caudal block could have direct effects on different hemodynamic parameters in pediatrics undergoing lower abdominal surgeries.

Methods: