Effects Of Caudal Block On Intraoperative Stress Response And Postoperative Intestinal Canal Function Recovery In The Pediatric Patients Undergoing Laparoscopic Operation Of Lower Abdomen

Objective: To compare the effect of general anesthesia versus caudal block combined with general anesthesia on intraoperative stress response and postoperative intestinal canal function recovery in the pediatric patients undergoing laparoscopic operation of lower abdomen.Methods: Sixty patients of both sexes,aged 1-3 yr,BMI 12-18kg/m2,of ASA physical status I orⅡ,were randomly divided into general anesthesia group(group A,n=30)and caudal block combined general anesthesia group(group B,n=30).The mean arterial pressure(MAP)and heat rate(HR)before anesthesia(T0,baseline),at 5 min after laryngeal mask was placed(T1),at 5min after operation(T2),the time for the end of surgery(T3),the time for removal of laryngeal mask(T4)were recorded.Before anesthesia(T0),and at 30 min after skin incision(T5),at 30 min after surgery(T6),blood samples were collected the peripheral vein for determine of the plasma NE,COR,IL-6,IL-10,IFABP by enzyme-linked immunosorbent assay.The time of preoperative fasting and water-deprivation,surgery time,the intraoperative consumption of propofol and remifentanil,the initial time of postoperative gas and stool,the second time of stool were recorded.Results: Compared with those at T0,the MAP and HR was both increased at T3,T4 in group A(P<0.05).Compared with those at T0,HR was increased at T2-4 in group B,but no significant change of MAP was found in group B(P>0.05).Compared with those at group A,the MAP and HR was significantly decreased in group B(P<0.05).Compared with those at T0,the concentration of COR,IL-10,IFABP was increased at T5,T6 in group A and B(P<0.05).Compared with those at group A,no significant change was found in the concentration of COR,IL-10,IFABP in group B(P>0.05).Compared with those at T0,the concentration of NE was increased at T5,6 in group A(P<0.05),but it was no significant change at T5,T6 in group B.Compared with those at T0,there was no significant change in the concentration of IL-6 in group A and B.Compared with those at group A,no significant change was found in the concentration of IL-6 in group B(P>0.05).There was no significant difference in intraoperative consumption of propofol,the time of preoperative fasting and water-deprivation,the initial time of postoperative gas and stool,the second time of stool among group A and B(P>0.05).Yet compared with those at group A,intraoperative consumption of remifentanil was decreased in group B(P<0.01).Conclusion: Caudal block combined general anesthesia inhibits the stress response caused by intraoperative nociceptive stimulus for pediatric patients undergoing laparoscopic operation of lower abdomen,but it has no effect on the stress response caused by intraoperative non-noxious stimulation as well as postoperative intestinal canal function recovery.