title: Awake caudals and epidurals should be used more frequently in neonates and infants.
abstract: The current literature provides fundamental insights regarding the neurotoxic potency of various general anesthetic drugs in neonates and small infants. Therefore, considerations to minimize the use of general anesthetic drugs in this age group are required. The use of caudal and epidural anesthesia under sedation is one possibility to minimize the use of general anesthetic drugs. A large number of surgical procedures can be managed with this anesthetic concept. Training, practical hand skills, good infrastructure, a well-defined indication, and a team approach including the entire operation room staff are the major prerequisites to implement these techniques in the daily clinical practice. This review article discusses all present aspects and possible future evolutions of caudal and epidural anesthesia under sedation.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Marhofer
authors.forename: Maya
authors.initials: M
authors.lastname: Keplinger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Klug
authors.forename: Martin L
authors.initials: ML
authors.lastname: Metzelder
mesh_terms: D000763:Anesthesia, Caudal / Q000379:methods*; D000767:Anesthesia, Epidural / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009407:Nerve Block / Q000379:methods
keywords: anesthesia caudal; anesthesia epidural; infant; sedation moderate; surgical procedures minimal invasive; ultrasonography