Epidural Anesthesia and Analgesia in the Neonate: a Review of Current Evidences

Overview

Journal J Anesth

Specialty Anesthesiology

Date 2014 Feb 14

PMID 24522812

Citations 9

Authors

Souvik Maitra

Dalim Kumar Baidya

Dilip K Pawar

Mahesh Kumar Arora

Puneet Khanna

Affiliations

Soon will be listed here.

Abstract

The role of single shot spinal anesthesia has been established in ex-premature infants at risk of apnea. However, use of epidural anesthesia in neonates is on the rise. In this systematic analysis, we have reviewed the current evidence on the safety and efficacy of the use of single shot and continuous epidural anesthesia/analgesia in neonates. Current clinical practice is guided by evidence based mostly on non-randomized studies, prospective/retrospective case series and surveys. Single shot caudal blockade as a sole technique has been used in neonates mainly for inguinal hernia repair and circumcision. Use of continuous epidural anesthesia through the caudal route or caudo-thoracic advancement of the catheter for major thoracic and abdominal surgery offers good perioperative analgesia. Other observed benefits are early extubation, attenuation of stress response, early return of bowel function and reduction of general anesthesia-related postoperative complications. However, risk of procedure-related and drug-related complications to the developing neural structure remains a serious concern.

Citing Articles

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Perioperative Ultrasound-Guided Continuous Caudal Epidural Analgesia in Newborns: A Case Series in a Tertiary Medical Center.

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Postoperative Analgesia in Neonates and Infants Using Epidural Chloroprocaine and Clonidine.

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Association of anesthesia type with prolonged postoperative intubation in neonates undergoing inguinal hernia repair.

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