Observational comparison of sevoflurane and nitrous oxide or caudal block in pediatric patients

Aim: Sevoflurane is the most preferred volatile anesthetic agent for the induction and maintenance of anesthesia in children. In our study, the analgesic component of general anesthesia was provided by N2O or caudal block and during anesthesia, the depth of the anesthesia was kept constant by means of the monitoring of bispectral index (BIS). We aimed to make an observational comparison the effects of these two methods on minimal alveolar concentration (MAC) and hemodynamics. Material and Methods: Forty pediatric patients scheduled to undergo on day case based surgery under general anesthesia were included in the study. Inhalation induction using 8% sevoflurane in a mixture of 40% O2/Air (group K) or 40% O2/N2O (group N) were used in all children. Then, patients in Group K received caudal block in lateral decubitus position with 0.7 mL/kg, 0.2% bupivacaine solution using 22 G caudal needle. Hemodynamic parameters, BIS and MAC values were recorded during the operation in all patients. Results: Hemodynamic parameters were similar in both groups. It was determined that sevoflurane was not statistically significant in the caudal block group without the contribution of N2O, but could be maintained in lower MAC values. Conclusion: We recommend use of caudal block since it ensures adequately satisfactory intraoperative and postoperative analgesia without any harm to atmosphere in comparison to N2O during general anesthesia in the presence of no medical contraindications