Caudal analgesia and anesthesia techniques in children

Current Opinion in Anaesthesiology
Ban C H Tsui, Charles B Berde

Abstract

Caudal epidural blockade remains the cornerstone of pediatric regional anesthesia. In this article we provide a comprehensive review of the recent developments in caudal anesthesia in infants and children. Research has focused on prolonging the duration of single-shot caudal blocks and accurately positioning continuous caudal catheters. New local anesthetics with similar potencies but less toxicity have been introduced. Opioids prolong the duration of analgesia of local anesthetic, but have also been associated with unacceptable side effects, particularly in pediatric outpatients. Various non-opioid adjuncts with more favorable side-effect profiles may increase the duration of analgesia. New ultrasound and nerve-stimulation techniques have been developed to accurately guide epidural catheters to a specific spinal level. The addition of ketamine or clonidine to a caudal local anesthetic prolong the duration of the block. However, a preservative-free preparation of ketamine that is suitable for neuraxial use is not widely available. Ultrasound imaging and electrical stimulation are promising options to accurately position a caudal needle. However, because ultrasound imaging is more difficult in older children, nerve stimulation i...Continue Reading

References

Mar 1, 1993·Journal of Clinical Anesthesia·K HendersonC B Berde
Aug 12, 1999·Anesthesiology·B C TsuiR Kearney
Jun 19, 2001·Brain Research·M ProescholdtO Kempski
Mar 15, 2002·Anesthesiology Clinics of North America·Santhanam Suresh, Melissa Wheeler
Apr 26, 2002·Anesthesia and Analgesia·Susan T VergheseKantilal M Patel
Apr 26, 2002·Anesthesia and Analgesia·Helmut HagerMargot Semsroth
Jun 13, 2002·Paediatric Anaesthesia·G Ivani
Sep 25, 2002·Paediatric Drugs·Joel B Gunter
Dec 19, 2002·British Journal of Anaesthesia·R M L'E Orme, S J Berg
Jan 10, 2003·Paediatric Anaesthesia·Hideaki HayashiSulpicio G Soriano
Jan 11, 2003·Neurotoxicology·John W Olney
Mar 20, 2003·British Journal of Anaesthesia·D A H de Beer, M L Thomas
May 20, 2003·Paediatric Anaesthesia·Dilek MemişZafer Pamukçu
Jun 7, 2003·Paediatric Anaesthesia·Charles R Schrock, Matthew Barry Jones
Sep 3, 2003·Paediatric Anaesthesia·Mark AnserminoCarolyne Montgomery
Oct 11, 2003·Paediatric Anaesthesia·M S ChawatheC Eickmann
Mar 19, 2004·Regional Anesthesia and Pain Medicine·Santhanam Suresh
Apr 17, 2004·Paediatric Anaesthesia·Charles Berde
Apr 17, 2004·Paediatric Anaesthesia·Adrian Bösenberg
Jun 29, 2004·Anesthesiology·Carl P C ChenHenry L Lew
Aug 28, 2004·Paediatric Anaesthesia·Sibel BarisEbru Kelsaka
Sep 24, 2004·Paediatric Anaesthesia·M PassarielloP Pietropaoli
Jan 29, 2005·Paediatric Anaesthesia·N AlmenraderP Pietropaoli
Oct 5, 2006·Current Opinion in Anaesthesiology·Christian Seefelder
Oct 6, 2006·Current Opinion in Anaesthesiology·Jane M Peutrell, Per-Arne Lonnqvist
Oct 6, 2006·Current Opinion in Anaesthesiology·Martin Jöhr, Thomas M Berger

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Citations

Oct 5, 2010·Indian Journal of Anaesthesia·Sukhminder Jit Singh BajwaAparajita Panda
Oct 1, 2011·Saudi Journal of Anaesthesia·Mahin SeyedhejaziMorteza Ghojazadeh
Dec 7, 2013·Surgical and Radiologic Anatomy : SRA·Jens KesslerThomas Grau
May 17, 2008·Paediatric Anaesthesia·Cari Meyer, Rachel Cambray
Dec 27, 2011·Neurological Research·R RiascosL Layer
Jun 9, 2014·Brazilian Journal of Anesthesiology·Zafer DoganMesut Garipardic
Dec 3, 2014·Brazilian Journal of Anesthesiology·Zafer DoganMesut Garipardic
Jun 28, 2007·The Journal of International Medical Research·F YeJ J Lin
Nov 22, 2013·Anesthesia and Analgesia·Zoher M NajaMariam A El-Rajab

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