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Intervertebral epidural anesthesia in 2,050 infants and children using the drip and tube method
Yoshiko Osaka1, Masao Yamashita
1Department of Anesthesiology, Ibaraki Children's Hospital, Mito, Japan.
Insights
Pediatric epidural anesthesia is safe and effective in over 2,000 cases. The drip and tube method for epidural anesthesia in children shows a high success rate with minimal complications.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pain Management
Background:
- Pediatric epidural anesthesia use has grown significantly.
- Data on success rates and complications remain incomplete.
Purpose of the Study:
- To evaluate the safety and effectiveness of pediatric epidural anesthesia.
- To analyze complication rates in infants and children.
Main Methods:
- Retrospective review of 2,050 pediatric epidural anesthesia cases.
- Utilized the drip and tube method for epidural space identification.
- Recorded success rates, complications, and effectiveness.
Main Results:
- High success rate for epidural block (96.4%) and first-attempt epidural space location (89.8%).
- Low incidence of complications: dural penetration (0.54%), spinal anesthesia (0.05%), bloody tap (0.34%), intravascular injection (0.20%).
- Complications were more common in patients weighing <=10 kg; no permanent neurological sequelae observed.
Conclusions:
- Epidural anesthesia using the drip and tube method is safe and practical for pediatric patients.
- The technique demonstrates a favorable risk-benefit profile in infants and children.
Background And Objectives:
Pediatric epidural anesthesia has increased in popularity in the last 2 decades, but its success rate and the frequency of complications has not been fully elucidated. We therefore reviewed our experience with 2,050 cases of epidural anesthesia in infants and children.
Methods:
We recorded the number of attempts at epidural space location, complications, and effectiveness in 2,050 cases of single-shot sacral intervertebral, lumbar, and thoracic epidural anesthesia. We used the drip and tube method for identification of the epidural space and administration of local anesthetic solution.
Results:
The overall rate of successful epidural block and epidural space location on the first attempt was 96.4% and 89.8%, respectively. Complications included uncomplicated dural penetration (0.54%), spinal anesthesia (0.05%), bloody tap (0.34%), and intravascular injection (0.20%). Complications were more frequent in patients
Conclusions:
Intervertebral epidural anesthesia using the "drip and tube" method is safe and practical in infants and children.