Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study

Background and Aims: Caudal block is among the most widely administered regional anesthesia in pediatric patients. The clinical signs and objective assessments are not fast and reliable enough to provide a good feedback. Perfusion index (PI) is considered as a sensitive marker to assess the efficacy...

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Main Authors: Sumedha Vashishth, Nancy Nandal, Kiranpreet Kaur, Yogender S. Kadian, Sanjay Johar, Svareen Kaur, Mamta Bhardwaj, Vaishali Mahor
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-01-01
Series:Journal of Anaesthesiology Clinical Pharmacology
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Online Access:https://journals.lww.com/10.4103/joacp.joacp_228_22
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author Sumedha Vashishth
Nancy Nandal
Kiranpreet Kaur
Yogender S. Kadian
Sanjay Johar
Svareen Kaur
Mamta Bhardwaj
Vaishali Mahor
author_facet Sumedha Vashishth
Nancy Nandal
Kiranpreet Kaur
Yogender S. Kadian
Sanjay Johar
Svareen Kaur
Mamta Bhardwaj
Vaishali Mahor
author_sort Sumedha Vashishth
collection DOAJ
description Background and Aims: Caudal block is among the most widely administered regional anesthesia in pediatric patients. The clinical signs and objective assessments are not fast and reliable enough to provide a good feedback. Perfusion index (PI) is considered as a sensitive marker to assess the efficacy of caudal block. We aim to assess PI as an indicator for success of caudal block in pediatric patients. Material and Methods: Sixty pediatric patients scheduled for elective surgery of lower abdomen and below were included. Patients were randomly allocated into two groups (n = 30): Group 1 received caudal block after general anesthesia and Group 2 only received general anesthesia. PI, heart rate, mean arterial pressure, and anal sphincter tone (AST) were recorded at 5, 10, 15, and 20 min following induction of anesthesia. Results: A persistent increase in the PI value was observed in Group 1 starting from 5 min till 20 min, as compared to Group 2, at all the time intervals. When mean PI was statistically compared between both the groups, it was found to be highly significant (P = 0.001). Group 1 patients have progressive laxity of AST which was found to be significantly different from Group 2 (P < 0.001). Conclusion: We have found that both PI and AST are good indicators for assessing success of caudal block onset in pediatric patients but AST took slightly longer time (~20 mins). Therefore, we conclude that PI is simple, economical, and noninvasive monitor that predicts the caudal onset much earlier than AST.
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spelling doaj-art-1f5bb29e93d84e7d9589b00c81b019c82024-12-17T07:02:56ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852024-01-0140110811310.4103/joacp.joacp_228_22Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized studySumedha VashishthNancy NandalKiranpreet KaurYogender S. KadianSanjay JoharSvareen KaurMamta BhardwajVaishali MahorBackground and Aims: Caudal block is among the most widely administered regional anesthesia in pediatric patients. The clinical signs and objective assessments are not fast and reliable enough to provide a good feedback. Perfusion index (PI) is considered as a sensitive marker to assess the efficacy of caudal block. We aim to assess PI as an indicator for success of caudal block in pediatric patients. Material and Methods: Sixty pediatric patients scheduled for elective surgery of lower abdomen and below were included. Patients were randomly allocated into two groups (n = 30): Group 1 received caudal block after general anesthesia and Group 2 only received general anesthesia. PI, heart rate, mean arterial pressure, and anal sphincter tone (AST) were recorded at 5, 10, 15, and 20 min following induction of anesthesia. Results: A persistent increase in the PI value was observed in Group 1 starting from 5 min till 20 min, as compared to Group 2, at all the time intervals. When mean PI was statistically compared between both the groups, it was found to be highly significant (P = 0.001). Group 1 patients have progressive laxity of AST which was found to be significantly different from Group 2 (P < 0.001). Conclusion: We have found that both PI and AST are good indicators for assessing success of caudal block onset in pediatric patients but AST took slightly longer time (~20 mins). Therefore, we conclude that PI is simple, economical, and noninvasive monitor that predicts the caudal onset much earlier than AST.https://journals.lww.com/10.4103/joacp.joacp_228_22caudal blockpediatricsperfusion index
spellingShingle Sumedha Vashishth
Nancy Nandal
Kiranpreet Kaur
Yogender S. Kadian
Sanjay Johar
Svareen Kaur
Mamta Bhardwaj
Vaishali Mahor
Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study
Journal of Anaesthesiology Clinical Pharmacology
caudal block
pediatrics
perfusion index
title Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study
title_full Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study
title_fullStr Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study
title_full_unstemmed Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study
title_short Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study
title_sort evaluation of perfusion index as a predictor of successful caudal block in pediatric patients a prospective randomized study
topic caudal block
pediatrics
perfusion index
url https://journals.lww.com/10.4103/joacp.joacp_228_22
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