title: Caudal anesthesia in pediatric cardiac surgery: does it affect outcome?
abstract: OBJECTIVE
  The purpose of this study was to examine the influence of caudal anesthesia on outcomes (pediatric intensive care unit [PICU] length of stay, hospital length of stay, ventilatory time, early extubation rate) in pediatric patients undergoing congenital heart disease repair requiring cardiopulmonary bypass (CPB).
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Pediatric patients undergoing surgery to treat congenital heart disease between 1999 and 2002.
  
  
  METHODS
  None.
  
  
  RESULTS
  Thirty-four patients with atrial septal defect (ASD), 37 with ventricular septal defect, and 46 with tetralogy of Fallot (TOF) were included in the analysis. No differences were found in preoperative and intraoperative data between caudal and noncaudal group for each disorder. There was no difference between caudal and noncaudal groups in PICU and hospital stay. A statistically significant difference was found in the postoperative ventilatory time in patients with ASD and TOF between caudal and noncaudal groups. The early extubation rate was higher in the TOF caudal group compared with the noncaudal group.
  
  
  CONCLUSIONS
  This retrospective study demonstrated that postinduction placement of caudal anesthesia does not affect PICU or hospital length of stay. A well-controlled prospective study is needed to confirm these findings.
authors.affiliation: Department of Anesthesiology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA. gleyvi@montefiore.org
authors.forename: Galina
authors.initials: G
authors.lastname: Leyvi
authors.forename: David G
authors.initials: DG
authors.lastname: Taylor
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Reith
authors.forename: Arabela
authors.initials: A
authors.lastname: Stock
authors.forename: Gregory
authors.initials: G
authors.lastname: Crooke
authors.forename: John D
authors.initials: JD
authors.lastname: Wasnick
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000763:Anesthesia, Caudal; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D009020:Morphine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine