Comparative Analysis of Hemodynamic Stability and Postoperative Recovery in Pediatric Lower Abdominal Surgery: Caudal vs. Spinal Anesthesia

Abstract

Background: Pediatric lower abdominal surgery requires effective anesthesia to ensure both hemodynamic stability and postoperative recovery. The choice between caudal and spinal anesthesia is critical in this regard. Objective: This study aimed to compare the hemodynamic stability and postoperative recovery in pediatric patients undergoing lower abdominal surgery with caudal versus spinal anesthesia. Methods: A prospective observational study was conducted from June 2023 to December 2024 at the Department of Anesthesiology, Kushtia Medical College Hospital. A total of 232 pediatric patients undergoing lower abdominal surgery were enrolled. The patients were divided into two groups based on anesthesia type: caudal (116 patients) and spinal (116 patients). Hemodynamic parameters (blood pressure, heart rate, oxygen saturation) were monitored throughout the surgery, and recovery metrics (time to first analgesic, incidence of postoperative nausea/vomiting, and time to full consciousness) were recorded postoperatively. Statistical analysis was performed using SPSS, with the significance level set at p<0.05. Results: Hemodynamic stability was significantly better in the caudal group, with a mean blood pressure variation of ±5.2 mmHg compared to ±8.3 mmHg in the spinal group (p<0.01). The caudal group also demonstrated a quicker recovery, with 73% of patients achieving full consciousness within 30 minutes compared to 57% in the spinal group. The time to first analgesic was significantly shorter in the spinal group (45 minutes vs. 75 minutes, p<0.05). Postoperative nausea/vomiting was lower in the caudal group (12% vs. 21%, p<0.05). The standard deviation of recovery time in the caudal group was 10.3, compared to 14.5 in the spinal group. Conclusion: Caudal anesthesia provided better hemodynamic stability and faster postoperative recovery compared to spinal anesthesia in pediatric lower abdominal surgeries.