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Effect of caudal block on perioperative stress level in children during urological operations

dc.contributor.advisorUram-Benka, Anna
dc.contributor.otherDrašković, Biljana
dc.contributor.otherSimić, Dušica
dc.contributor.otherRakić, Goran
dc.contributor.otherVicković, Sanja
dc.contributor.otherRadovanović, Dragana
dc.creatorMarina, Pandurov
dc.date.accessioned2020-07-15T10:46:51Z
dc.date.available2020-07-15T10:46:51Z
dc.date.issued2020-07-10
dc.identifier.urihttps://www.cris.uns.ac.rs/DownloadFileServlet/Disertacija157978123620074.pdf?controlNumber=(BISIS)113932&fileName=157978123620074.pdf&id=14693&source=NaRDuS&language=srsr
dc.identifier.urihttps://www.cris.uns.ac.rs/record.jsf?recordId=113932&source=NaRDuS&language=srsr
dc.identifier.urihttps://www.cris.uns.ac.rs/DownloadFileServlet/IzvestajKomisije157978124326331.pdf?controlNumber=(BISIS)113932&fileName=157978124326331.pdf&id=14694&source=NaRDuS&language=srsr
dc.identifier.uri/DownloadFileServlet/IzvestajKomisije157978124326331.pdf?controlNumber=(BISIS)113932&fileName=157978124326331.pdf&id=14694
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/17211
dc.description.abstractHirurška inetrvencija aktivira odgovor organizma na stres, pokreću se neuroendokrine promene u organizmu, što rezultira neželjenom hemodinamskom nestabilnošću, promenama metabolizma, endokrinog i imunog sistema. Cilj ovog istraživanja je bio da se utvrdi uticaj kaudalnog bloka na nivo perioperativnog stresa i njegova efikasnot u zbrinjavanju intra- i postoperativnog bola. Ovo prospektivno, randomizirano kliničko ispitivanje obuhvatalo je 80 dečaka, uzrasta 2-5godina, kojima su bile indikovane urološke operacije. Jedna grupa (n = 38) je primila opštu anesteziju, a druga (n = 38) opštu anesteziju sa kaudalnim blokom. Mereni su intraoperativno hemodinamski parametri u 8 merenja, ukupna potrošnja svih datih lekova i intenzitet bola u 3 navrata postoperativno. Uzorci krvi uzeti su pre uvoda u anesteziju i nakon buđenja pacijenta, i ispitivan je nivo glukoze, kortizola, leukocita, leukocitarne formule, pH i laktata. Deca koja su primila kaudalni blok imala su, postoperativno, značajno niži nivo glukoze u serumu (p <0,01), koncentracije kortizola (p <0,01), leukocita i neutrofila (p <0,01), laktata i acidoze, a takođe su imali i niže ocene bola u sve tri momenta merenja (p<0,01). Intraoperativno utvrđena je veća hemodinamska stabilnost i manja potrošnja analgetika perioperativno. Takođe, u toj grupi nije bilo komplikacija. Kombinacija kaudalnog bloka sa opštom anestezijom je bezbedna metoda, koja dovodi do manjeg stresa, veće hemodinamske stabilnosti, nižih ocena bola i manje potrošnje lekova.sr
dc.description.abstractSurgery generates a neuroendocrine stress response, resulting in undesirable haemodynamic instability, alterations in metabolic response and malfunctioning of the immune system. The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods. This prospective, randomized clinical trial included 80 patients scheduled for elective urological operations. One group (n = 38) received general anaesthesia and the other (n = 38) received general anaesthesia with a caudal block. Haemodynamic paramethers, drug consumption and pain intensity were measured. Blood samples for serum glucose, cortisol level, leukocytes, pH and lactate level were taken before anaesthesia induction and after awakening the patient. Children who received a caudal block had, postoperativly, significantly lower serum glucose (p < 0.01), cortisol concentrations (p < 0.01), leukocytes (p<0,01), lower lactate level and acidosis,also pain scores were lower at all 3 measurments (p<0,01). Intraoperativly greater haemodynamic stability and lower drug consumption were noticed. Also, there were no side effects or complications identified in that group. The combination of caudal block with general anaesthesia is a safe method that leads to less stress, greater haemodynamic stability, lower pain scores and lower consumption of medication.en
dc.languagesr (latin script)
dc.publisherУниверзитет у Новом Саду, Медицински факултетsr
dc.rightsAttribution-NonCommercial-NoDerivs
dc.sourceУниверзитет у Новом Садуsr
dc.subjectkaudalna anestezija; opšta anestezija; predškolska deca; urološke hirurške metode; postoperativni bol; perioperativni period; merenje bolasr
dc.subjectAnesthesia, Caudal; Anesthesia, General; Child, Preschool; Urologic Surgical Procedures; Pain, Postoperative; Intraoperative Period; Pain Measurementen
dc.titleUticaj kaudalnog bloka na nivo perioperativnog stresa kod dece tokom uroloških operacijasr
dc.title.alternativeEffect of caudal block on perioperative stress level in children during urological operationsen
dc.typeDoktorska disertacijasr
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/64052/IzvestajKomisije.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/64051/Disertacija.pdf


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