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19 lip 2016 · Epidurals provide optimal analgesia whilst avoiding opioid-related side effects, with studies demonstrating fewer episodes of hypoxaemia or respiratory depression and a reduced need for postoperative ventilation and intensive care (3).
Epidural anesthesia and analgesia in otherwise healthy children rarely causes cardiovascular instability. The occurrence of hypotension should raise the suspicion of total spinal anesthesia and/or an intravascular injection leading to local anesthetic toxicity.
Epidural analgesia has widespread use in infants and children for postoperative pain management and for certain chronic pain conditions such as cancer pain and complex regional pain syndrome.
Epidural analgesia offers numerous benefits in the pediatric surgical patient. It is commonly used to augment general anesthesia and to manage postoperative pain (for 48–72 h) with minimal hemodynamic alteration. The latter stems from low resting sympathetic tone and reduced blood in lower extremities in children. [1] .
With proper patient selection, based on a careful risk/benefit analysis, epidural analgesia is extremely effective in children. The block chosen should be tailored to the anticipated postoperative pain, surgical procedure and the child's underlying condition.
Newer techniques have now superseded pediatric epidural analgesia (PEA), being as effective and safer, especially with the advances in ultraso-nography. PEA is, however, still an important technique to master and employ, and it may be that the indications for this mode of analgesia have now become more defined.
This leaflet aims to provide information for parents of children who may benefit from an epidural for pain relief after surgery. The information in this leaflet will be discussed with you by an anaesthetist, or a member of the pain team.
