Caudal Anesthesia for Pediatric Surgery. An Easy and Safe Method for Calculating Dose Requirements

Mel'man, E. P.; Arenas, Joaquı́n; Tandazo, W. E.

doi:10.1097/00000542-198509001-00463

Cited by 9 publications

(6 citation statements)

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“…The HIM is a public and tertiary‐care children's medical centre and paediatric anaesthesia is one of the residency programs offered at the institution for more than 20 years. For many years, caudal block has been our main anaesthetic technique for numerous abdominal procedures (10,11). A failed caudal block is always a possibility due to the very common sacral anatomical variations (9).…”

Section: Discussionmentioning

confidence: 99%

“…However, in our experience, it has been associated with a high success rate and a low incidence of adverse events. Unfortunately, our accumulated experience has been poorly documented (10,11) but might prove interesting, especially in view of the ongoing discussion on the comparative toxicity of bupivacaine, ropivacaine and levobupivacaine.…”

Section: Introductionmentioning

confidence: 99%

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Caudal block with 4 mg·kg⁻¹ (1.6 ml·kg⁻¹) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Moyao‐García

Garza‐Leyva

Velázquez-Armenta

et al. 2002

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Caudal block with 4 mg·kg⁻¹ (1.6 ml·kg⁻¹) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Moyao‐García

Garza‐Leyva

Velázquez-Armenta

et al. 2002

Pediatric Anesthesia

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“…After gentle aspiration to corroborate the position and negative aspiration of either blood or cerebrospinal fluid, the local anaesthetic agent was injected. The volume of the local anaesthetic was calculated according to a procedure described previously elsewhere 14 . Drugs and volume‐adjusted doses were prepared by one of the authors (FTAG) and caudal block was performed by another (RG) who was blinded to these details.…”

Section: Methodsmentioning

confidence: 99%

Dose–response of Ropivacaine Administered Caudally to Children Undergoing Surgical Procedures Under Sedation With Midazolam

Aguirre-Garay

García

Nava-Ocampo

2004

Clin Exp Pharma Physio

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1. In a double-blind randomized controlled design, 50 children were allocated to receive bupivacaine 0.25% or ropivacaine 0.25%, 0.32%, 0.40% or 0.50% by caudal block. 2. Caudal block was performed after induction of anaesthesia with 2-5% sevoflurane, atropine 10 microg/kg and midazolam 100-300 microg/kg. During the surgical procedure, patients were maintained under spontaneous ventilation and no intravenous or inhalatory anaesthetic agent was administered. For transoperative sedation, midazolam 100-300 microg/kg was administered every 0.5-1.0 h. Transoperative cardiovascular response, postoperative analgesia and local and systemic complications were evaluated. 3. Groups were similar (P > 0.05) in sex, age, weight and in the time elapsed from caudal block to the beginning of the surgical procedure. The surgical time was significantly lower in the ropivacaine 0.25% group. The duration of analgesia was 24 h with ropivacaine 0.25% and approximately 10 h in the other four groups (P < 0.001). Linear regression analysis revealed a significant relationship between the postoperative analgesic period produced by ropivacaine and the surgical time (r = -0.48, two-sided P = 0.002). Systolic and diastolic blood pressures remained in the physiologically normal range for the duration of the transoperative period. Vomiting was present in only one patient receiving ropivacaine 0.50%. 4. In children, the duration of analgesia produced by caudal block with ropivacaine may be affected by surgical time. At surgical times of 0.5-1 h, ropivacaine 0.25% produced at least 24 h postoperative analgesia. At similar surgical times, ropivacaine 0.32%, 0.40% and 0.50% produced similar analgesic times to bupivacaine 0.25%.

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“…Although the first successful spinal anesthesia was performed in an 11‐year old by August Bier in 1898, and the first caudal anesthesia was performed in 1933, in the mid‐20th century, US doctors rarely performed regional anesthesia in children . Working initially in a cadaver laboratory to determine the doses of local anesthetic needed to achieve satisfactory dermatomal spread, and then with children in IRB‐approved research trials, Melman et al was among the first to demonstrate the effectiveness of neural blockade, particularly the caudal approach to the epidural space, in pediatric anesthesia. Indeed, her original study was met with substantial skepticism and was rejected by one of the editors at Anesthesia and Analgesia .…”

Section: Background Historymentioning

confidence: 99%

At the birth of pediatric anesthesia in Mexico: An interview with Dr. Estela Melman, a pioneering woman in medicine

Ahmed

Mai

Skinner

et al. 2018

Pediatric Anesthesia

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Summary Dr. Estela Melman (1939‐present), Professor in the Department of Anesthesiology, the American British Cowdray Medical Center, Mexico, is an influential pioneer who has shaped the scope and practice of pediatric anesthesia in Mexico and throughout the world. Her early work to reintroduce neural blockade into routine pediatric anesthetic care, particularly the caudal approach to the epidural space, helped to transform current anesthesia practice. Based on a series of interviews held with Dr. Melman between 2016 and 2017, this article reviews the remarkable career of a pioneering pediatric anesthesiologist.

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Caudal Anesthesia for Pediatric Surgery. An Easy and Safe Method for Calculating Dose Requirements

Cited by 9 publications

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Caudal block with 4 mg·kg⁻¹ (1.6 ml·kg⁻¹) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Caudal block with 4 mg·kg⁻¹ (1.6 ml·kg⁻¹) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Dose–response of Ropivacaine Administered Caudally to Children Undergoing Surgical Procedures Under Sedation With Midazolam

At the birth of pediatric anesthesia in Mexico: An interview with Dr. Estela Melman, a pioneering woman in medicine

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Caudal Anesthesia for Pediatric Surgery. An Easy and Safe Method for Calculating Dose Requirements

Cited by 9 publications

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Caudal block with 4 mg·kg−1 (1.6 ml·kg−1) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Caudal block with 4 mg·kg−1 (1.6 ml·kg−1) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Dose–response of Ropivacaine Administered Caudally to Children Undergoing Surgical Procedures Under Sedation With Midazolam

At the birth of pediatric anesthesia in Mexico: An interview with Dr. Estela Melman, a pioneering woman in medicine

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Caudal block with 4 mg·kg⁻¹ (1.6 ml·kg⁻¹) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis

Caudal block with 4 mg·kg⁻¹ (1.6 ml·kg⁻¹) of bupivacaine 0.25% in children undergoing surgical correction of congenital pyloric stenosis