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The national pediatric epidural audit.
1Acute Pain Service, Birmingham Children's Hospital NHS Trust, Birmingham, UK. dgl_nel@yahoo.co.uk
Paediatric Anaesthesia
|May 15, 2007
Summary
Pediatric epidural infusion analgesia (EIA) carries risks, with serious events rare (1:2000). This audit provides data to improve informed consent for parents regarding the safety of epidural analgesia in children.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Clinical Audit
Background:
- Prospective audit of pediatric epidural infusion analgesia (EIA) in Great Britain and Ireland.
- Aim: Quantify risks associated with pediatric EIA.
Purpose of the Study:
- To establish a national audit of EIA practice in pediatric pain services.
- To collect data on the number of pediatric epidurals and incidence of adverse events.
Main Methods:
- National audit of EIA practice from 2001-2005.
- Monthly returns of EIA numbers; detailed forms for incidents.
- Incident severity grading (1-3) and 1-year follow-up where possible.
Main Results:
- 96 incidents reported in 10,633 epidurals.
- 5 serious (Grade 1) incidents (approx. 1:2000).
- 1 child with residual effects from a Grade 1 incident (approx. 1:10,000).
- Compartment syndrome not masked by EIA.
Conclusions:
- Pediatric EIA has associated risks, but serious events are infrequent.
- EIA does not mask compartment syndrome.
- Audit data enhances informed consent for parents regarding pediatric epidural analgesia.
