[Epidural analgesia for postoperative pain in infants and children].
Until recently it was thought that children do not suffer as much from postoperative pain as adults. Coupled with the fear of administering systemic opiates to young children, this meant that babies were often left "to cry it out." Lately it has been acknowledged that children and even babies not only feel pain, but similar to adults, suffer from the physiologic consequences of the untreated stress response. It has also been shown that preventing this response improves the postoperative period in babies after undergoing cardiac surgery. Regional analgesia is commonly used to provide postoperative pain control in adults and children. Following minor lower abdominal surgery, pain relief is often provided by caudal analgesia or specific nerve blocks. Epidural and spinal anesthesia are also gaining popularity for young children and even babies. We describe 3 cases of continuous epidural analgesia in babies, and review other methods for postoperative pain relief. These cases are representative of the many which we have treated over the past 2 years. We use epidural analgesia in children who undergo major thoracic, abdominal, pelvic and major lower limb surgery, and are expected to suffer significant postoperative pain for more than 24 hours. We have not encountered any major complications or inadvertent dural punctures. We judiciously monitor these children, especially their respiratory function, as long as they receive epidural narcotics.
Efrat
R
R
Dept. of Pediatric Anesthesia, Schneider Children's Medical Center, Hadassah Medical School, Jerusalem.
Oppenheim
A
A
Weiss
Y
Y
Kedari
A
A
D000328:Adult; D000367:Age Factors; D015360:Analgesia, Epidural; D003125:Colostomy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy*