{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:59:40Z","timestamp":1787169580827,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Measurement of biomarkers representing sympathetic tone and the surgical stress response are helpful for objective comparison of anesthetic protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>A prospective observational study at a tertiary cardiac center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Methods:<\/jats:title>\n                    <jats:p>\n                      Sixty pediatric cardiac surgical patients were randomized to Group I [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 30] to receive intravenous narcotic-based anesthesia and Group II [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis:<\/jats:title>\n                    <jats:p>Pearson's Chi-squared test was used for comparison of categorized variables, and Mann\u2013Whitney test was used for the analysis of continuous data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Changes in chromogranin A levels and blood sugar levels were comparable in both groups. Group II received a lower narcotic dosage (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.001), and the response to skin incision as reflected by systolic pressure rise was less (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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 levels.<\/jats:p>\n                  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