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Published on: June 2, 2022
[Caudal anesthesia in pediatric surgery]
G S Aprodu1, V Munteanu, Georgiana Filciu
1Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Spitalul clinic Sf. Maria" Iaşi, Clinica de Chirurgie şi Ortopedie Pediatrică.
Insights
Caudal anesthesia effectively manages intraoperative and postoperative pain in pediatric patients. This technique, particularly when combined with general anesthesia, is highly beneficial for infants and young children.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Regional Anesthesia
Context:
- Pediatric surgical procedures require effective pain management strategies.
- Caudal anesthesia is a common technique for intraoperative and postoperative analgesia in children.
- Assessing the safety and efficacy of caudal blocks is crucial for optimizing pediatric care.
Purpose:
- To analyze the efficacy and safety of caudal anesthesia for intraoperative and postoperative pain control in pediatric patients.
- To evaluate the outcomes of caudal blocks in different age groups and anesthetic combinations.
- To identify the most frequent complications associated with caudal anesthesia in children.
Summary:
- A retrospective study reviewed 150 pediatric patients undergoing various surgical procedures using caudal anesthesia.
- The technique demonstrated high efficacy, with 85.33% achieving very good analgesia.
- The overall morbidity rate was 13.33%, with urinary retention being the most common complication (5.33%).
Impact:
- Caudal anesthesia is confirmed as an efficient method for pediatric pain management.
- The findings support the use of caudal blocks, especially with general anesthesia, for infants and young children.
- This study provides valuable data for anesthesiologists regarding the safety profile and effectiveness of caudal anesthesia in pediatric populations.
Unlabelled:
The study analyses the efficacy and the safety of caudal anesthesia for the intra and postoperative pain management in children.
Material And Method:
A retrospective study was conducted over a five years period enrolling 150 children scheduled for various surgical procedures. We used the standard technique ("loss of resistance", "single shot", lateral decubitus).
Results:
The most important age groups were 1 month - 1 year, 64 cases (42.66%) and 1-6 years - 71 cases (47.33%). We performed 144 caudal blocks associated with general anesthesia, 3 associated with sedation and 3 simple caudal blocks. In 129 cases, we used bupivacaine 0.25% as a single analgetic substance, in five cases bupivacaine 0.25% with lidocaine 1%, and in 16 cases bupivacaine 0.25% with fentanyl 1 mcg/kg. The quality of the analgesia was very good in 128 cases (85.33%), good in 12 (8%) and poor in 10 cases (6.66%). The morbidity rate was 13.33% (20 cases), the most frequent complication being urinary retention (8 cases - 5.33%).
Conclusions:
The caudal block is an efficient procedure for intra and postoperative analgesia in children. Associated with general anesthesia it is very useful for the management of the age groups 1 month - 1 year and 1-6 years.
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