title: [Benefits of epidural analgesia in major neonatal surgery].
abstract: The aim of this paper is to describe and evaluate the benefits of epidural anesthesia in major surgery neonatal. We have performed a matched case-control (2:1) study of patients undergoing neonatal major surgery (NMSs) who received intra-and postoperative epidural anesthesia (EA) and controls with conventional general anesthesia. The matching criteria were age, weight and baseline pathology. EA was administered by caudal puncture and epidural catheter placed with ultrasound support. Levobupivacaine was selected as anesthetic drug. The time to extubation, intestinal transit time, type of analgesia and complications were studied. This study is based on 11 cases (2 esophageal atresia, 2 diaphragmatic hernias, 1 necrotizing enterocolitis, 3 intestinal atresia, 2 anorectal malformation and 1 bladder exstrophy) and 22 controls. We observed statistically significant differences in time to extubation (95% CI OR 12 1.99 to 72.35; Chi2 p = 0.004, Mann U Whytney p = 0.013) and intestinal transit time (Mann Whitney U p < 0.001, 100 Or, 95% CI 8.06-1 239; Chi2 p < 0.0001). There were no complications from epidural analgesia. Therefore we believe that the intra-and postoperative EA helps improve postoperative management in neonates and should be preferred in centers where this technique is available.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Universitario y Politécnico La Fe, Valencia. javi_gomez14@hotmail.com
authors.forename: J
authors.initials: J
authors.lastname: Gómez-Chacón
authors.forename: J
authors.initials: J
authors.lastname: Encarnación
authors.forename: M
authors.initials: M
authors.lastname: Couselo
authors.forename: L
authors.initials: L
authors.lastname: Mangas
authors.forename: A
authors.initials: A
authors.lastname: Domenech
authors.forename: C
authors.initials: C
authors.lastname: Gutiérrez
authors.forename: C
authors.initials: C
authors.lastname: García Sala
mesh_terms: D015360:Analgesia, Epidural; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013514:Surgical Procedures, Operative