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Sacral intervertebral approach for epidural anaesthesia in infants and children: application of "drip and tube"
1Department of Anaesthesia, Ibaraki Children's Hospital, Mito, Japan.
Insights
The sacral intervertebral approach offers a safe and effective method for pediatric epidural anesthesia. Utilizing the "drip and tube" technique enhances success rates in infants and children.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Procedures
Background:
- The sacral intervertebral approach was established in 1987 as an alternative to the caudal approach for pediatric epidural anesthesia.
- This technique is considered anatomically straightforward in infants and children.
Purpose of the Study:
- To evaluate the efficacy and safety of the sacral intervertebral approach for single-shot epidural anesthesia in pediatric patients.
- To assess the utility of the "drip and tube" method for identifying the epidural space.
Main Methods:
- Single-shot epidural anesthesia was administered to 200 infants and children using the sacral intervertebral approach.
- The "drip and tube" method involved connecting a micro-drip infusion set to the epidural needle to identify the epidural space by observing fluid dripping.
- Local anesthetic was injected using the "immobile needle" technique via an IV extension tube.
Main Results:
- The overall success rate of the epidural block was 96%.
- The "drip and tube" method facilitated reliable identification of the epidural space.
Conclusions:
- The sacral intervertebral approach is a viable and anatomically suitable method for pediatric epidural anesthesia.
- The "drip and tube" technique improves the safety and success rate of single-shot pediatric epidural anesthesia.
Abstract:
Sacral intervertebral approach to the epidural space was introduced as an alternative to the caudal approach in infants and children in 1987. We performed single-shot epidural anaesthesia in 200 infants and children with this approach using the "drip and tube" method for identification of the epidural space. Identification of the epidural space was marked by commencement of dripping in the chamber of a micro-drip infusion set which was connected to the epidural needle. With the i.v. extension tube, local anaesthetic solution was injected by the "immobile needle" technique. Overall success rate of the block was 96%. This approach to the epidural space is anatomically easy in infants and children, and application of our "drip and tube" method might make the paediatric single-shot epidural anaesthesia safer and more successful.