[Epidural anesthesia in children under 3 months of age. Apropos of 49 cases].
This retrospective study includes 45 patients (age: 32 +/- 28 days; weight: 4,077 +/- 988 g) who underwent epidural analgesia with a catheter for various surgical operations. Epidural space was detected by the loss of resistance to air technique. The anaesthetic solution administered was bupivacaine 0.25% with 1/200,000 epinephrine. Four technical failures were recorded; intraoperative analgesia was adequate for all other patients. In 17 patients, postoperative analgesia was maintained by continuous infusion (0.125% bupivacaine or 0.25% lidocaine: 0.2 mL.kg -1.h-1). In 18 patients, it was managed by iterative injections (0.25% bupivacaine with epinephrine: 0.25 mL.kg -1.h-1). In 10 patients, a single shot was sufficient. Postoperative analgesia was found to be inadequate in four patients. No incidents or accidents were recorded. A benefit-risk analysis with the support of the literature attempts to define the main indications of this method.
Courrèges
P
P
Clinique Chirurgicale Pédiatrique, Hôpital Saint-Antoine, Lille.
Lecoutre
D
D
Poddevin
F
F
Bayart
R
R
D000767:Anesthesia, Epidural / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010149:Postoperative Pain / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D013514:Surgical Procedures, Operative
D000779:Anesthetics, Local; D002045:Bupivacaine