Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain Management1993-65082687-1394Eco-Vector4288510.17816/RA42885Research ArticleCAUDAL ANESTHESIA IN SURGICAL INTERVENTIONS ON THE LOWER EXTREMITIES IN CHILDRENNasibovaEsmira M.associate professor of thr Department of Pediatric Surgery, Azerbaijan Medical University, Аz 1065, Baku, Azerbaijandoc.nasibova.esmira@gmail.comIsmailovI. S-NasibovF. G-SattarovN. S-Azerbaijan Medical University1506201812211311724082020Copyright © 2018, Eco-Vector2018The goal of the study: Comparative study of the effects of bupivacin and ropivacaine in caudal anesthesia in surgical interventions on the lower extremities in children. Material and methods. 59 children operated under caudal anesthesia for congenital dislocation of the thigh, deformities of pelvic bones, clubfoot, etc. were included in the study. The patients were divided into 2 groups depending on the type of local anesthetic used: in group I (n = 39) caudal anesthesia was performed with a 0.75% solution of ropivacaine with intravenous sedation with propofol; in the second group (n = 20), the caudal block was administered with a 0.5% solution of bupivacaine. During the operation and in the postoperative period, the indices of central hemodynamics, the concentration of cortisol and blood plasma glucose were studied, the intensity of postoperative pain syndrome was assessed. Results. Serious complications of anesthesia were not recorded. The indices of central hemodynamics remained stable during anesthesia, the indices of stress markers decreased somewhat, which indicates the adequacy of both variants of anesthesia. Twelve hours after the operation, a significant increase in the cardiac index, heart rate and blood pressure, as well as an increase in the concentration of cortisol and glucose, was noted in Group II patients who had anesthesia with bupivacaine. This was accompanied by an intensive pain syndrome, which required an additional appointment of tramadol. In group I patients (caustic anesthesia with ropivacaine), the indices of central hemodynamics and stress markers remained stable after the operation, and the intensity of the pain syndrome was significantly lower. Conclusions. Caudal anesthesia with 0.75% ropivacaine is a highly effective, reliable and safe method of anesthesia in traumatological operations on the lower extremities in children. Caudal administration of a 0.75% ropivacaine provides a longer sensory and motor block compared with a 0.5% bupivacaine. The superiority of caudal anesthesia with ropivacaine is due to the more potent and prolonged action of the drug, as evidenced by the wider spread of the sensory block, deeper motor blockade, stability of hemodynamic parameters and stress markers.caudal blockropivacainebupivacaineкаудальный блокбупивакаинропивакаин[Сичкарь С.Ю. Эпидуральная анальгезия у новорожденных в периоперационном и послеоперационном периоде. Анестезиология и реаниматология. 2015; 3: 65-8.][Кулагин А.Е. и соавт. Каудальная анестезия в педиатрии. Здравоохранение. 2012; 4: 35-8.][Memtsoudis S., Sun Y., Chiu Y., Stundner O., Liu S. Perioperative comparative effectiveness of anesthtic technique in orthopedic patients. Anesthesiology. 2013; 118: 1046-58.][Bouchut J.C., Dubois R., Foussat C. et al. Evaluation of caudal anaesthesia performed in conscious ex-premature infants for inguinal herniotomies. Paediatrю Anaesth. 2001; 11: 55-8.][De Beer D.A.H., Thomas Mh. Caudal additives in children-solutions or problems? Br. J. Anaesth. 2003; 90: 487-98.][Zwass M.S. Regional anesthesia in children. Anesthesiology Clin. N. Am. 2005; 23: 815-35.][Ivani G., DeNegri P., Conio A. et al. Comparison of racemic bupivacaine, ropivacaine, and levo-bupivacaine for pediatric caudal anesthesia: effects on postoperative analgesia and motor block. Red. Anesth. Pain Med. 2002; 27: 157-61.][Groban l., Dolinski S.Y. Differences in cardiac toxicity among ropivacaine, levobupivacaine, bupivacaine and lidocaine. Techniques in regional anesthesia and pain management. 2001; 5: 48-55.][Aizemberg V.L. et al. Regional anesthesia in pediatric vertebralogy. Regionarnaya anesteziya i lechenie ostroy boli. 2015; 9 (4): 39-47. (in Russian).][Abukawa Y. et al. Ultrasound versus anatomical landmarks for caudal epidural anesthesia in pediatric. BMC Anesthesiology. 2015; 15: 234-42.][Айзенберг В.Л. и соавт. Регионарная анестезия в детской вертебрологии. Регионарная анестезия и лечение острой боли. 2015; 9 (4): 39-47]