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Caudal epidural blockade in adolescents

BACKGROUND: Various options are available for the provision of analgesia following major surgical procedures including systemic opioids and regional anesthetic techniques. Regional anesthetic techniques offer the advantage of providing analgesia while avoiding the deleterious adverse effects associa...

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Autores principales: Schloss, Brian, Jayanthi, Venkata R., Bhalla, Tarun, Tobias, Joseph D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657927/
https://www.ncbi.nlm.nih.gov/pubmed/23717234
http://dx.doi.org/10.4103/1658-354X.109812
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author Schloss, Brian
Jayanthi, Venkata R.
Bhalla, Tarun
Tobias, Joseph D.
author_facet Schloss, Brian
Jayanthi, Venkata R.
Bhalla, Tarun
Tobias, Joseph D.
author_sort Schloss, Brian
collection PubMed
description BACKGROUND: Various options are available for the provision of analgesia following major surgical procedures including systemic opioids and regional anesthetic techniques. Regional anesthetic techniques offer the advantage of providing analgesia while avoiding the deleterious adverse effects associated with opioids including nausea, vomiting, sedation and respiratory depression. Although used commonly in infants and children, there is a paucity of experience with the use of caudal epidural blockade in adolescents. METHODS: We retrospectively reviewed the perioperative care of adolescents undergoing major urologic or orthopedic surgical procedures for whom a caudal epidural block was placed for postoperative analgesia. RESULTS: The cohort for the study included 5 adolescents, ranging in age from 13 to 18 years and in weight from 42 to 71 kilograms. Caudal epidural analgesia was accomplished after the induction of anesthesia and prior to the start of the surgical procedure using 20-25 mL of either 0.25% bupivacaine or 0.2% ropivacaine with clonidine (1 μg/kg). The patients denied pain the recovery room. The time to first request for analgesia varied from 12 to 18 hours with the patients requiring 1-3 doses of analgesic agents during the initial 24 postoperative hours. CONCLUSIONS: Our preliminary experience demonstrates the efficacy of caudal epidural block in providing analgesia following major urologic and orthopedic surgical procedures. The applications of this technique as a means of providing postoperative analgesia are discussed.
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spelling pubmed-36579272013-05-28 Caudal epidural blockade in adolescents Schloss, Brian Jayanthi, Venkata R. Bhalla, Tarun Tobias, Joseph D. Saudi J Anaesth Original Article BACKGROUND: Various options are available for the provision of analgesia following major surgical procedures including systemic opioids and regional anesthetic techniques. Regional anesthetic techniques offer the advantage of providing analgesia while avoiding the deleterious adverse effects associated with opioids including nausea, vomiting, sedation and respiratory depression. Although used commonly in infants and children, there is a paucity of experience with the use of caudal epidural blockade in adolescents. METHODS: We retrospectively reviewed the perioperative care of adolescents undergoing major urologic or orthopedic surgical procedures for whom a caudal epidural block was placed for postoperative analgesia. RESULTS: The cohort for the study included 5 adolescents, ranging in age from 13 to 18 years and in weight from 42 to 71 kilograms. Caudal epidural analgesia was accomplished after the induction of anesthesia and prior to the start of the surgical procedure using 20-25 mL of either 0.25% bupivacaine or 0.2% ropivacaine with clonidine (1 μg/kg). The patients denied pain the recovery room. The time to first request for analgesia varied from 12 to 18 hours with the patients requiring 1-3 doses of analgesic agents during the initial 24 postoperative hours. CONCLUSIONS: Our preliminary experience demonstrates the efficacy of caudal epidural block in providing analgesia following major urologic and orthopedic surgical procedures. The applications of this technique as a means of providing postoperative analgesia are discussed. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC3657927/ /pubmed/23717234 http://dx.doi.org/10.4103/1658-354X.109812 Text en Copyright: © Saudi Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Schloss, Brian
Jayanthi, Venkata R.
Bhalla, Tarun
Tobias, Joseph D.
Caudal epidural blockade in adolescents
title Caudal epidural blockade in adolescents
title_full Caudal epidural blockade in adolescents
title_fullStr Caudal epidural blockade in adolescents
title_full_unstemmed Caudal epidural blockade in adolescents
title_short Caudal epidural blockade in adolescents
title_sort caudal epidural blockade in adolescents
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657927/
https://www.ncbi.nlm.nih.gov/pubmed/23717234
http://dx.doi.org/10.4103/1658-354X.109812
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