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From the Journal archives: Epidural anesthesia in young children: what have we learned in the past 60 years?

Robin G Cox1

  • 1Department of Anesthesia, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail N.W., Calgary, AB, T3B 6A8, Canada, robin.cox@albertahealthservices.ca.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|November 20, 2013
PubMed

Insights

Single-shot epidural anesthesia is effective and safe for pediatric patients undergoing surgery below the diaphragm. This 1954 study highlights its efficacy and provides techniques still relevant today for pediatric epidural anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia Techniques
  • Surgical Patient Management

Background:

  • This study reviews the application of single-shot epidural anesthesia in pediatric patients.
  • The research spans from 1949 to 1954, detailing patient management and anesthetic efficacy.
  • It aims to assess indications, effectiveness, and potential complications of epidural anesthesia in children.

Observation:

  • The author utilized epidural anesthesia in 44 pediatric cases, with a total of 77 procedures involving infants and children.
  • Pyloric stenosis was a common indication for the procedure.
  • The sitting position and hanging drop technique were identified as optimal for epidural needle insertion.

Findings:

  • Epidural anesthesia provided excellent surgical conditions and profound relaxation in pediatric patients.
  • Sedation was sometimes necessary to achieve optimal surgical conditions.
  • All patients survived the procedures, with one unrelated mortality due to intestinal obstruction.

Implications:

  • Epidural anesthesia is a viable and effective option for various infra-diaphragmatic procedures in infants and children.
  • The findings suggest its utility even in critically ill pediatric patients.
  • The described techniques and insights remain valuable for contemporary pediatric anesthesiology practice.
Abstract

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