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[Epidural anesthesia in children under 3 months of age. Apropos of 49 cases]

P Courrèges1, D Lecoutre, F Poddevin

  • 1Clinique Chirurgicale Pédiatrique, Hôpital Saint-Antoine, Lille.

Cahiers D'Anesthesiologie
|January 1, 1996
PubMed

Insights

Epidural analgesia using bupivacaine and epinephrine provided effective pain relief for pediatric surgical patients. While technical failures were minimal, further analysis is needed to optimize its use.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Care

Context:

  • Epidural analgesia is a common technique for managing pain in pediatric surgical patients.
  • The study evaluated the use of epidural catheters for various surgical operations in neonates and infants.
  • The loss of resistance to air technique was employed for epidural space identification.

Purpose:

  • To assess the efficacy and safety of epidural analgesia in pediatric patients undergoing surgery.
  • To analyze different methods of postoperative pain management using epidural techniques (continuous infusion, iterative injections, single shot).
  • To conduct a benefit-risk analysis of epidural analgesia in this population, supported by literature review.

Summary:

  • A retrospective study of 45 pediatric patients (32 +/- 28 days; 4,077 +/- 988 g) receiving epidural analgesia with bupivacaine and epinephrine.
  • Four technical failures occurred; intraoperative analgesia was adequate for the remaining patients.
  • Postoperative analgesia management varied, with some patients receiving continuous infusion, iterative injections, or a single shot, achieving generally adequate pain control with no reported incidents.

Impact:

  • This study contributes to understanding the effectiveness and safety profile of epidural analgesia in pediatric surgery.
  • Findings can help guide the selection of appropriate epidural techniques for postoperative pain management in neonates and infants.
  • The benefit-risk analysis aims to clarify the primary indications for epidural catheter use in pediatric surgical patients.

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