Evaluation of Perfusion Index (PI) Efficiency in Pediatric Caudal Block: Is it the Time to Depend on PI?

Objective: This study was conducted to evaluate the efficiency of Perfusion Index (PI) as indicator of pediatric caudal block in comparison with Mean Arterial Pressure (MAP) and Heart Rate (HR). Methods: 140 patient children (2-8 year old) were randomized into two groups: Group I (n=70) were anesthetized by 8% inhalation sevoflurane followed by caudal block using lmL.kg^-1 lidocaine (1%) under 3% inhalation sevoflurane with fentanyl and; group II (n=70) were anesthetized by 8% inhalation sevoflurane anesthesia then decreased to 3% with fentanyl only. Cremastric Reflex (CR) also was done to both groups after induction of the anesthesia. Results: In group I, PI significantly increased (p 0.01) after 2min of caudal anesthesia and MAP significantly decreased after 5min of caudal anesthesia (p 0.05), while HR insignificant increased as compared to baseline (TO). In group II, no significant changes were detected in PI, HR and MAP as compared to the baseline. Also PI increased significantly befor loss (CR). Conclusion: This concludes that PI is efficient, highly sensitive indicator to assess the early onset of caudal block than other parameters (HR and MAP). PI is more earlier indicator than absence of CR.