title: Comparison of the effect of sevoflurane and halothane anesthesia on the fall in heart rate as a predictor of successful single shot caudal epidural in children.
abstract: OBJECTIVE
  To investigate the effect of sevoflurane anesthesia on heart rate HR fall with the injection of the initial drug in caudal space to confirm the correct needle placement.
  
  
  METHODS
  After the ethical approval was obtained from the hospital's ethics committee, a prospective, randomized, clinical study was designed in Yeditepe University Hospital, in 2007. Children aged 1-12 years, scheduled for infraumbilical surgery under general anesthesia, and caudal block were included in the study. Anesthesia was induced, and maintained by sevoflurane in group S (n=85), and by halothane in group H (n=82). Baseline HR was recorded before the caudal block was performed. The HR changes during the initial dose, and total drug injection were recorded followed by 2 more HR recordings taken 5, and 10 minutes after caudal injection. The success of the block was recorded by a blind observer.
  
  
  RESULTS
  There were 167 children included in the study. Caudal block success was 96.5% in group S, and 97.6% in group H. Basal HR was 110.9 +/- 10.9 in group S, and 105.9 +/- 10.1 in group H. Following the initial drug injection, mean HR was 109.8 +/- 10.9 in group S, and 102.9 +/- 9.9 in group H. It was significantly lower than the baseline in group H. The only significant decrease in the HR of the patients in group S was at the tenth minute following caudal injection.
  
  
  CONCLUSIONS
  The decrease in HR with drug injection has no value to predict the success of caudal block under sevoflurane anesthesia.
authors.affiliation: Department of Anesthesiology, Saad Specialist Hospital, PO Box 30353, Al-Khobar 31952, Kingdom of Saudi Arabia. arzumercan66@hotmail.com
authors.forename: Arzu
authors.initials: A
authors.lastname: Mercan
authors.forename: Hatice
authors.initials: H
authors.lastname: Ture
authors.forename: Murat M
authors.initials: MM
authors.lastname: Sayin
authors.forename: Selami
authors.initials: S
authors.lastname: Sozubir
authors.forename: Ozge
authors.initials: O
authors.lastname: Koner
authors.forename: Bora
authors.initials: B
authors.lastname: Aykac
mesh_terms: D000767:Anesthesia, Epidural; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006221:Halothane / Q000008:administration & dosage / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008738:Methyl Ethers / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane
chemical_list: D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane