Complications in regional anaesthesia

Goldman, Luis

doi:10.1111/j.1460-9592.1995.tb00234.x

Cited by 56 publications

(15 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Addition of epinephrine to LA reduces the total dose, increases the safety margin, and prolongs the duration (up to 30%), but its use has been questioned because of fear of cord ischemia. [55] Dexmedetomidine, a new α 2 agonist, has been used as an additive via epidural route in children, but not intrathecally. Though various LA and additives used for SA have been reported to be relatively safe, but the potential spinal cord toxicity with the drugs delivered intrathecally during early phases of development cannot be precluded.…”

Section: Introductionmentioning

confidence: 99%

Spinal anesthesia in children: A review

Gupta

Saha

2014

J Anaesthesiol Clin Pharmacol

121

View full text Add to dashboard Cite

Even after a vast safety record, the role of spinal anesthesia (SA) as a primary anesthetic technique in children remains contentious and is mainly limited to specialized pediatric centers. It is usually practiced on moribund former preterm infants (<60 weeks post-conception) to reduce the incidence of post-operative apnea when compared to general anesthesia (GA). However, there is ample literature to suggest its safety and efficacy for suitable procedures in older children as well. SA in children has many advantages as in adults with an added advantage of minimal cardio-respiratory disturbance. Recently, several reports from animal studies have raised serious concerns regarding the harmful effects of GA on young developing brain. This may further increase the utility of SA in children as it provides all components of balanced anesthesia technique. Also, SA can be an economical option for countries with finite resources. Limited duration of surgical anesthesia in children is one of the major deterrents for its widespread use in them. To overcome this, several additives like epinephrine, clonidine, fentanyl, morphine, neostigmine etc. have been used and found to be effective even in neonates. But, the developing spinal cord may also be vulnerable to drug-related toxicity, though this has not been systematically evaluated in children. So, adjuvants and drugs with widest therapeutic index should be preferred in children. Despite its widespread use, incidence of side-effects is low and permanent neurological sequalae have not been reported with SA. Literature yields encouraging results regarding its safety and efficacy. Technical skills and constant vigilance of experienced anesthesia providers is indispensable to achieve good results with this technique.

show abstract

Section: Introductionmentioning

confidence: 99%

Spinal anesthesia in children: A review

Gupta

Saha

2014

J Anaesthesiol Clin Pharmacol

121

View full text Add to dashboard Cite

show abstract

“…This requirement for a sedated or anaesthetised patient removes the potential warning signals of parathesia due to needle trauma to nerves or inadvertent intraneural injection during the block and prevents the use of a test dose to indicate intrathecal injection of local anaesthetic solution [73]. Compared with adults, children usually have softer ligaments and a smaller epidural space and there is less room for error.…”

Section: Techniquementioning

confidence: 99%

Epidural and subarachnoid blockade in children

Rowney

Doyle

1998

Anaesthesia

View full text Add to dashboard Cite

“…[1][2][3][4] While it is generally considered safe, major complications may arise from its use. 5 Large-scale studies conducted in adults have reported an incidence of transient or permanent neurological injury of 1-8 in 10,000 epidurals. [6][7][8][9][10][11][12][13] There is a paucity of studies examining major complications related to epidural analgesia in children.…”

Section: Résumémentioning

confidence: 99%

Major complications related to epidural analgesia in children: a 15-year audit of 3,152 epidurals

Wong

Arab

Chew

et al. 2013

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Background Complications associated with epidural analgesia in children have a reported incidence of 40-90 in 10,000 epidurals. We sought to determine the incidence of major complications with the use of continuous epidural analgesia that occurred in our centre over the past 15 years and to describe the nature of these complications. Methods The Acute Pain Service database at a tertiary care academic pediatric hospital was reviewed retrospectively over a 15-year period. Data were categorized according to patient age (neonate, infant, child one through eight years, and child [ eight years), mode of insertion of the epidural (caudal, transsacral, lumbar, thoracic), complication type, and complication severity. Results Over the 15-year period, 3,152 epidurals were performed. The use of caudal-thoracic epidurals in neonates and infants has increased since 2007. Twenty-four major complications were identified (incidence, 7.6 in 1,000 epidurals). The rate of complications in neonates

show abstract

Complications in regional anaesthesia

Cited by 56 publications

References 57 publications

Spinal anesthesia in children: A review

Spinal anesthesia in children: A review

Epidural and subarachnoid blockade in children

Major complications related to epidural analgesia in children: a 15-year audit of 3,152 epidurals

Contact Info

Product

Resources

About