Caudal epidural block in children and infants: retrospective analysis of 2088 cases

• Published in: Annals of Saudi medicine Vol. 31; no. 5; pp. 494 - 497
• Main Authors: Beyaz, Serbülent Gökhan, Tokgöz, Orhan, Tüfek, Adnan
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Medknow Publications and Media Pvt. Ltd 01-09-2011; KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTRE; Medknow Publications
• Subjects: Anesthesia; Anesthesia, Caudal - adverse effects; Anesthesia, Caudal - methods; Anesthetics, Local - administration & dosage; Anesthetics, Local - adverse effects; Babies; Bupivacaine - administration & dosage; Bupivacaine - adverse effects; Bupivacaine - analogs & derivatives; Care and treatment; Child; Child, Preschool; Children; Children & youth; Diagnosis; Epinephrine - administration & dosage; Epinephrine - adverse effects; Female; Fentanyl - administration & dosage; Fentanyl - adverse effects; Health aspects; Humans; Infant; Infant, Newborn; Infants; Laryngeal Masks; Male; Morphine - administration & dosage; Morphine - adverse effects; Nerve Block - adverse effects; Nerve Block - methods; Original; Retrospective Studies; Side effects; Spinal diseases; Saudi Arabia
• ISSN: 0256-4947; 0975-4466
• DOI: 10.4103/0256-4947.84627

Regional anesthesia is usually preferred as caudal block via the epidural space. However, the number of large-scale studies including pediatric caudal blocks is small. The objective of this study was to evaluate complications and side effects of local anesthetics and adjuvant drugs.
Retrospective, descriptive study of cases occurring during the period December 2007 to October 2009.
Of 4815 medical records were screened, 2088 pediatric cases were identified and included in this study.
As a local anesthetic, we preferred mostly levobupivacaine in 1669 (79.9%) patients and bupivacaine in 419 (20.1%) patients. As adjuvant drug, we preferred mostly morphine (41 patients), fentanyl (7 patients) and adrenaline (6 patients) in 54 (2.5%) patients. For general anesthesia induction, we preferred mostly propofol (1996 patients, 94.2%); for maintenance, sevoflurane (1773 patients, 84.9%). For airway control, we preferred mostly the ProSeal laryngeal mask (PLMA), in 1008 (48.2%) patients. One thousand six hundred five (76.9%) patients were from outpatient clinics and 483 (23.1%) patients were from inpatient clinics. No permanent complication was encountered after caudal blocks.
We conclude that caudal epidural blocks are a safe and effective method for subumbilical day-case pediatric surgeries when performed by anesthetists.