Lumbar and thoracic epidural analgesia via the caudal approach for postoperative pain relief in infants and children

Deborah K. Rasch, Dawn E. Webster, Trevor G. Pollard, Mary Ann Gurkowski

Resultado de la investigación: Articlerevisión exhaustiva

35 Citas (Scopus)


Thirty infants scheduled for a variety of gastrointestinal, genitourinary and thoracic surgical procedures were selected for insertion of lumbar or thoracic epidural catheters via the caudal approach using either an Intracath® or a Burron® continuous brachial plexus kit. The catheters were inserted with ease by residents in training and no catheter-related complications were encountered. Lidocaine 0.5 per cent with 1:200,000 epinephrine was then injected to assure proper placement of the catheter before narcotics were administered. Postoperative analgesia was adequate in all patients using preservative-free morphine 0.05 mg · kg- 1. The mean dosing interval was 15 hr and no episodes of nausea, vomiting, hypotension or histamine release were noted. Urinary retention occurred in two infants and one infant became apnoeic three hours after epidural morphine administration but responded to naloxone and pulmonary ventilation with bag and mask. In conclusion, epidural catheters placed via the caudal approach are a safe and effective means of providing postoperative pain control in infants using preservative-free morphine. However, the use of epidural narcotics in infants less than two years of age is restricted to those who will receive intensive care unit monitoring postoperatively so that if apnoea occurs, rapid intervention can be taken by-skilled nursing personnel.

Idioma originalEnglish (US)
Páginas (desde-hasta)359-362
Número de páginas4
PublicaciónCanadian Journal of Anaesthesia
EstadoPublished - abr 1990
Publicado de forma externa

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


Profundice en los temas de investigación de 'Lumbar and thoracic epidural analgesia via the caudal approach for postoperative pain relief in infants and children'. En conjunto forman una huella única.

Citar esto