The Comparative Effects of Caudal Block and IV Ketorolac on Emergence Delirium after Sevoflurane Anesthesia in Children / 대한마취과학회지

ABSTRACT

BACKGROUND: Children usually exhibit pain-related behavior in the postanesthetic care unit. The aim of the present study was to compare the recovery and emergence profiles of children who received sevoflurane with caudal block or IV ketolorac or none for inguinal herniorrhaphy. METHODS: Forty five children, ASA 1, scheduled for herniorrhaphy were randomly assigned to receive either caudal block(n = 15), IV ketorolac (n = 15), or none (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 mask inhalation of sevoflurane 2 vol% in N2O/O2 50/50 were used to induce anesthesia. After induction, group 1 received none, while groups 2 and 3 received a caudal block and IV ketorolac, respectively. Anesthesia was maintained by sevoflurane with N2O/O2 inhalation via an endotracheal tube. Recovery was assessed by an independent observer using a postansthetic recovery score. Pain score was also assessed by an independent observer using a pain/discomfort scale. Recovery and agitation characteristics on emergence were compared between the three groups. RESULTS: There were no difference between the groups with respect to age, weight, duration of inhalation exposure, or recovery score. Agitation and pain scores were less in both the caudal block and IV ketorolac groups (P <0.05). Emergence delirium occurred less frequently in the caudal block and IV ketorolac groups (P <0.05). There was no significant difference between the caudal block and the IV ketorolac groups in emergence delirium. CONCLUSIONS: Emergence delirium after sevoflurane anesthesia was less common in the caudal block and IV ketorolac groups. Thus, it is presumed that the postoperative analgesic actions of caudal block or IV ketorolac reduce emergence delirium during recovery from sevoflurane anesthesia.