Assessment of Stress Response Attenuation with Caudal Morphine Using a Surrogate Marker During Pediatric Cardiac Surgery

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dc.contributor.authorMaddali, Madan Mohanen_US
dc.contributor.authorShamsi, Fathiya Alen_US
dc.contributor.authorArora, Nishant Ramen_US
dc.contributor.authorVenkatachlam, Ramachandhiranen_US
dc.contributor.authorSathiya, Panchatcharam Murthien_US
dc.date.accessioned2023-07-14T08:00:28Z
dc.date.available2023-07-14T08:00:28Z
dc.date.issued2022-03
dc.description.abstractBackground:Measurement of biomarkers representing sympathetic tone and the surgical stress response are helpful for objective comparison of anesthetic protocols. Aims: The primary aim was to compare changes in chromogranin A levels following pump pediatric cardiac surgery between children who received bolus caudal morphine and those who received a conventional intravenous narcotic?based anesthesia regime. The secondary objectives were to compare hemodynamic responses to skin incision and the magnitude of the rise in blood sugar values between the groups. Settings and Design: A prospective observational study at a tertiary cardiac center. Measurements and Methods: Sixty pediatric cardiac surgical patients were randomized to Group I [n = 30] to receive intravenous narcotic?based anesthesia and Group II [n = 30] to receive single?shot caudal morphine. Baseline and postoperative chromogranin A levels, the hemodynamic response to skin incision, changes in blood sugar levels, and the total intravenous narcotic dose administered were recorded for each participant. Statistical Analysis: Pearson’s Chi?squared test was used for comparison of categorized variables, and Mann–Whitney test was used for the analysis of continuous data. Results: Changes in chromogranin A levels and blood sugar levels were comparable in both groups. Group II received a lower narcotic dosage (P ? 0.001), and the response to skin incision as reflected by systolic pressure rise was less (P = 0.006). Conclusions: Surgical stress response attenuation was similar to caudal morphine as compared with intravenous narcotic?based anesthesia techniques as reflected by a similar increase in chromogranin A levelsen_US
dc.identifier.affiliationsDepartment of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscaten_US
dc.identifier.affiliationsAnesthesia Residency Training Programen_US
dc.identifier.affiliationsDepartment of Studies and Research, Oman Medical Specialty Board, Muscat, Omanen_US
dc.identifier.citationMaddali Madan Mohan, Shamsi Fathiya Al, Arora Nishant Ram, Venkatachlam Ramachandhiran, Sathiya Panchatcharam Murthi. Assessment of Stress Response Attenuation with Caudal Morphine Using a Surrogate Marker During Pediatric Cardiac Surgery. Annals of Cardiac Anaesthesia. 2022 Mar; 25(1): 61-66en_US
dc.identifier.issn0974-5181
dc.identifier.issn0971-9784
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/219266
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber1en_US
dc.relation.volume25en_US
dc.source.urihttps://doi.org/10.4103/aca.ACA_6_20en_US
dc.subjectAnesthesiaen_US
dc.subjectcardiac surgical proceduresen_US
dc.subjectcaudal/methodsen_US
dc.subjectchromogranin Aen_US
dc.subjectchromogranins/blooden_US
dc.subjectcongenital/surgeryen_US
dc.subjectheart defectsen_US
dc.subjectphysiological/blooden_US
dc.subjectstressen_US
dc.titleAssessment of Stress Response Attenuation with Caudal Morphine Using a Surrogate Marker During Pediatric Cardiac Surgeryen_US
dc.typeJournal Articleen_US
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