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Continuing Education in Anaesthesia, Critical Care & Pain 2006 6(2):63-66; doi:10.1093/bjaceaccp/mkl001
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 2 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Epidural analgesia for children

Davandra Patel, MB ChB FRCA
Consultant Paediatric Anaesthetist, Department of Anaesthesia, Royal Manchester Children's Hospital Hospital Road, Swinton, Manchester M27 4HA, UK Tel: 0161 922 2433 Fax: 0161 922 2439 E-mail: davandra.patel@cmmc.nhs.uk (for correspondence)
The first 150 words of the full text of this article appear below.


Key points

Epidural analgesia is useful as part of a multimodal approach to acute and chronic pain management in children.

The single S+-isomers, ropivacaine and levobupivacaine, are the drugs of choice in paediatric practice.

In infants below 6 months, epidural additives should not be used because concerns about spinal cord toxicity and the risk of apnoea remain unanswered.

An imaginary line drawn between the two superior iliac crests (intercristal line) is below the lower level of the spinal cord at any age.

Thoracic epidural placement in young children should be performed by clinicians experienced in the technique in this patient group.

 

Epidural analgesia is now firmly established in paediatric anaesthetic practice and its popularity continues to grow. Despite the lack of controlled studies in children, the combination of excellent pain relief associated with minimal side-effects provides high patient satisfaction when compared with other methods of analgesia. Consideration should be given . . . [Full Text of this Article]


   Local anaesthetic agents
 
Pharmacokinetic considerations

Drugs and dosage

Test dose

Additives


   General considerations
 
Anatomy

New techniques and indications for epidural block


   Caudal epidural analgesia
 
Indications

Technique

Drugs and doses

Complications


   Lumbar epidural analgesia
 
Technique

Drugs and dosages

Complications


   Thoracic epidural analgesia
 

   Conclusion
 

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