Intervertebral epidural anesthesia in 2,050 infants and children using the drip and tube method.

Abstract

Pediatric epidural anesthesia has increased in popularity in the last 2 decades, but its success rate and the frequency of complications has not been fully elucidated. We therefore reviewed our experience with 2,050 cases of epidural anesthesia in infants and children. We recorded the number of attempts at epidural space location, complications, and effectiveness in 2,050 cases of single-shot sacral intervertebral, lumbar, and thoracic epidural anesthesia. We used the drip and tube method for identification of the epidural space and administration of local anesthetic solution. The overall rate of successful epidural block and epidural space location on the first attempt was 96.4% and 89.8%, respectively. Complications included uncomplicated dural penetration (0.54%), spinal anesthesia (0.05%), bloody tap (0.34%), and intravascular injection (0.20%). Complications were more frequent in patients </=10 kg body weight. There were no permanent neurological sequelae. Intervertebral epidural anesthesia using the "drip and tube" method is safe and practical in infants and children.