Caudal epidural block (CEB) is one of the most preferred pediatric regional anesthesia methods for infants and children who need operations under umbilicus level, for example urogenital, rectal, inguinal, lower extremity surgeries. CEB is relatively easy to perform and provides efficient analgesia for both intraoperative and postoperative period. Although there are some studies which report caudal anaesthesia as the sole anaesthetic method in particular cases for infants and children, caudal anaesthesia is still combined with general anaesthesia for most of the cases. Caudal blockade can be a safe and effective analgesia technique in suppressing some elements of the hormonal stress response. Caudal block, in combination with light general anesthesia, may be useful inpremature children, those with comorbidity, as well as those with specific medical diseases such as cardiac disease or muscular atrophy. However, the risks and benefits of caudal epidural blockade must be considered on an individual basis . Stress responses to surgical insult and postoperative pain elicit changes in hormonal secretion. Surgery is associated with metabolic and endocrine responses characterized by hyperglycemia, an increase in adrenocorticotropic hormone, cortisol, prolactin, antidiuteric hormone, growth hormone, catecholamines, angiotensin II, aldosterone, glucagons, IL-1 and lactate, and a decrease in insulin and testosterone. Epidural analgesia inhibits the metabolic and endocrine stress responses associated with lower abdominal surgery. |
