The effect of epidural bupivacaine on maintenance requirements of sevoflurane evaluated by bispectral index in children

Abstract

Combined anaesthesia with epidural bupivacaine maintains the same Bispectral index values as Balanced anaesthesia during orthopaedic surgery in children without fentanyl and with a lower sevoflurane requirement.

Monitoring the anaesthetic depth in children – an update

“…The BIS falls with caudal block during general anaesthesia (in older children, but not in infants) [24,25] and falls during spinal anaesthesia in infants [26].…”

Emergence and Recovery Characteristics After Low Flow Anaesthesia With Desflurane and Sevoflurane in Cancer Patients Administered Combined Epidural and General Anaesthesia

“…Lower end-tidal concentrations of sevoflurane were required when general anaesthesia was supplemented with caudal bupivacaine in paediatric patients. [9] Lidocaineadministered for epidural anesthesia has been reported to reduce the MAC of sevoflurane by approximately 50%. [5] Epidural morphine reduces the MAC of halothane by 28% and isoflurane by 14%.…”

Perioperative effects of caudal and transversus abdominis plane (TAP) blocks for children undergoing urologic robot-assisted laparoscopic surgery

“…Regional anesthetic blocks are often used in combination with general anesthesia for pediatric surgery and have been shown to reduce general anesthetic requirements, pain, opioid use, and postoperative nausea and vomiting across a wide range of open surgical procedures [1][2][3][4]. It remains uncertain, however, if adjunctive regional anesthesia provides benefits to children undergoing laparoscopic or robot-assisted laparoscopic (RAL) surgery.…”

“…It may also be secondary to less need for general anesthetic agents. Standardized measurement of inhalational anesthetic requirements is not feasible in a retrospective study such as this, but two prospective trials of children undergoing lower extremity procedures demonstrated that caudal blocks decrease sevoflurane consumption[1,2].…”