title: Single-dose caudal anaesthesia for two infants undergoing diagnostic brain magnetic resonance imaging: high risk and nonhigh risk.
abstract: We present a case report of two infants given a bupivacaine caudal anaesthetic as a means of achieving sedation for a diagnostic brain magnetic resonance imaging (MRI). Patient 1 was born at 27 weeks of gestation and presented to our hospital at 39 weeks postconception with a history of bronchopulmonary dysplasia and apnoea/bradycardia spells. He was undergoing a brain MRI for the work up of persistent apnoea and craniofacial abnormalities. Patient 2 was a term infant at 42 weeks postconception undergoing a MRI for the work up of a seizure disorder. Both infants fell asleep shortly after placement of the caudal blocks and the studies were completed successfully without complications. Utilizing this technique, we avoided dealing with a potentially difficult airway (patient 1), exacerbating postoperative apnoea and the negative implications of intravenous sedation during a study where there is limited access to the patient's airway.
authors.affiliation: Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. brian.sites@hitchcock.org
authors.forename: Brian D
authors.initials: BD
authors.lastname: Sites
authors.forename: George
authors.initials: G
authors.lastname: Blike
authors.forename: Joseph
authors.initials: J
authors.lastname: Cravero
authors.forename: Steven
authors.initials: S
authors.lastname: Andeweg
authors.forename: Michael
authors.initials: M
authors.lastname: Beach
mesh_terms: D000763:Anesthesia, Caudal; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001049:Apnea / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002045:Bupivacaine / Q000627:therapeutic use*; D019465:Craniofacial Abnormalities / Q000473:pathology; D004827:Epilepsy / Q000473:pathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine