Biomedical Science Doctorate Proves Combination of General Anesthesia and Ropivacaine Continuous Caudal Blockade Has the Potential to Suppress Inflammation and Pain and Accelerate Early Nutrition in Children After Urethroplasty

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  • Rabu, 4 Maret 2026
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Biomedical Science Doctorate Proves Combination of General Anesthesia and Ropivacaine Continuous Caudal Blockade Has the Potential to Suppress Inflammation and Pain and Accelerate Early Nutrition in Children After Urethroplasty


Held in the Meeting Room on the Third Floor of the Postgraduate Program Building, Jl. PB Sudirman, Denpasar, Bali, the Biomedical Science Doctoral Study Program, Faculty of Medicine, Udayana University, held an open doctoral promotion defense with candidate Dr. I Putu Kurniyanta, Sp.An.KAP., for a dissertation entitled "The Effects of Combination of General Anesthesia with Ropivacaine Continuous Caudal Blockade Compared to General Anesthesia on Interleukin-1β, Interleukin-6, Pain, Early Enteral Nutrition, and Length of Hospitalization in Pediatric Patients After Urethroplasty." (3/2/2026)


Surgery results in increased stimulation of the sympathetic nervous system, characterized by increased hypothalamic-pituitary-adrenal cortex function and hyperfunction of the renin-angiotensin-aldosterone system. This is characterized by increased levels of cortisol, interleukins, aldosterone, and other hormones secreted into the bloodstream and directly mediating inflammatory and pain responses. Urethroplasty surgery sometimes requires repeated procedures in pediatric patients, resulting in psychological stress and severe pain due to inflammation. This prompted researchers to develop a technique combining general anesthesia with continuous caudal block to further improve outcomes by assessing inflammatory biomarkers (IL-1β and IL-6) pre- and post-surgery, clinical outcomes of pain, nutritional support, and length of hospital stay after surgery.


This experimental study involved 34 pediatric patients aged 1 to 10 years undergoing urethroplasty. The study was divided into two groups: the combined general anesthesia with continuous caudal block with Ropivacaine and the general anesthesia group. There was a smaller increase in serum IL-1β levels in the combination of general anesthesia with continuous caudal block Ropivacaine compared to general anesthesia in pediatric patients after urethroplasty (157.26 (281.16) vs 417.89 (361.55), p = 0.009) as well as in IL-6 levels (6.19±5.43 vs 12.88±9.85; p = 0.02). Postoperative FLACC pain scores were lower at 24 hours in pediatric patients undergoing urethroplasty with a combination of general anesthesia and continuous caudal Ropivacaine block compared to general anesthesia (p < 0.001), and enteral nutrition administration was faster (95 (32.5 vs 120 (177.5), p = 0.013). There was no difference in length of hospital stay between the two groups (3 (2) vs 3 (1.5), p = 0.786).


The combination of general anesthesia with continuous caudal Ropivacaine block resulted in improved outcomes in inflammatory biomarkers (IL-1β and IL-6), pain clinical outcomes, nutritional support, and length of hospital stay.


This trial was led by the Dean of the Faculty of Medicine, Udayana University, Prof. Dr. dr. I Gede Eka Wiratnaya, Sp.OT., Subsp.Onk.Ort.R(K)., with the following examiners:

1. Prof. Dr. dr. Tjok Gde Agung Senapathi, Sp.An-TI,, Subsp.An.R(K) (Promoter)

2.Dr. Dr. Ida Ayu Ika Wahyuniari, S.Ked., M.Kes (Copromotor (II)

3. Prof. Dr. Dr. I Wayan Putu Sutirta Yasa, M.Sc

4. Prof. Dr. Dr. I Made Jawi, M. Kes

5. Prof. Dr. Dr. I Made Muliarta, S.Ked., M.Kes

6.Dr. Dr. I Made Gede Widnyana, M.Kes., Sp.An-TI., Subsp.An.R(K)

7.Dr. Dr. I Made Pande Dwipayana, Sp.PD-KEMD., FINASIM

8.Dr. Dr. I Gusti Putu Hendra Sanjaya, Sp.B., Sp.BP-RE., Subsp.LBL(K)

9.Dr. Dr. I Wayan Eka Sutyawan, Sp.M(K)


By academic invitation:

1. Dr. dr. I Gusti Agung Gede Utara Hartawan, Sp.An-TI., MARS., SH

2. Dr. dr. Made Agus Hendrayana, M.Ked

3. Dr. dr. I Nyoman Gede Wardana, S.Ked., M.Biomed

4. Dr. dr. I Wayan Aryabiantara, Sp.An-TI., Subsp.T.I.(K)

5. Dr. dr. I Putu Pramana Suarjaya, Sp.An., M.Kes, KMN., KNA., FIPM


In this examination, Dr. dr. I Putu Kurniyanta, Sp.An.KAP., was declared the 481st Doctoral Graduate of the Biomedical Sciences Doctoral Study Program, Faculty of Medicine, Udayana University, with Cum Laude honors.


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