Safety of post-operative epidural analgesia in the paediatric population: A retrospective analysis

Kasanavesi, Ramakrishna Chaitanya; Gazula, Suhasini; Pula, Ravikanth; Thakur, Nagarjuna

doi:10.4103/0019-5049.167494

Cited by 13 publications

(9 citation statements)

References 16 publications

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“…During maintenance of epidural such as peri catheter leaks in 2, catheter migration in 3, during removal such as infections in 5 and other causes were seen in 1 cases. Kasanavesi et al [7] conducted a study to analyze all the complications that occured during administration and maintenance of EIA in pediatric patients. All children undergoing elective or emergency surgeries under general anaesthesia and given concomitant epidural analgesia for post-operative pain management were included.…”

Section: Discussionmentioning

confidence: 99%

Assessment of complications of epidural infusion analgesia in pediatric patients- A clinical study

Sharma¹

2018

Int. J. Med. Anesthesiology

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Background: Epidural analgesia is now firmly established in pediatric anaesthetic practice and its popularity continues to grow. The present study was conducted to determine complications due to epidural infusion analgesia in children. Materials & Methods:The present study was conducted on 52 patients of both genders. All children undergoing elective or emergency surgeries under general anaesthesia and given concomitant epidural analgesia for post-operative pain management. In all patients, complications such as at the time of insertion, during maintenance -nerve injuries, and during removal -catheter breakage was recorded. Results: Out of 52 cases, males were 32 and females were 20. Complications in patients were at the time of insertion such as blood trap in 2, failure to identify space in 1, wet tap in 4, epidural hematoma in 1 and nerve injuries in 1. The difference was significant (P< 0.05). During maintenance of epidural such as peri-catheter leaks in 2, catheter migration in 3, during removal such as infections in 5 and other causes were seen in 1 cases. The difference was significant (P< 0.05). Conclusion:Authors stated that epidural infusion analgesia is an effective and safe method of providing analgesia.

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Section: Discussionmentioning

confidence: 99%

Assessment of complications of epidural infusion analgesia in pediatric patients- A clinical study

Sharma¹

2018

Int. J. Med. Anesthesiology

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“…9 The frequency of leakage around the epidural has been reported to be 15%. 14 An obvious predisposing cause of this is that the epidural catheters are inserted through the Tuohy needles, and are of smaller diameter. In our study, 18-19G Tuohy needles were used with 20-23G catheters.…”

Section: Discussionmentioning

confidence: 99%

An Audit of 829 Paediatric Epidurals in a Tertiary Singapore Hospital: Complications and Conundrums

Wong

Lim²

2017

Ann Acad Med Singap

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Introduction: The incidence of complications related to epidural analgesia remains less well defined in the paediatric population as compared to adults. A retrospective review of prospectively collected data was performed to review and quantify risks of both adverse events and complications related to epidural analgesia in our Singaporean paediatric population. Materials and Methods: Data from the Acute Pain Service (APS) was prospectively collected over 19 years. Details included the age of the patients, level of insertion of the epidural catheter, number of attempts, staff grade of the practitioner, adverse events and complications. Results: Collectively, 829 epidurals were performed from 1 June 1997 to 31 May 2016. No deaths or major complications occurred within the 16-year period. There were 5 instances of dural puncture (0.6%). The incidence of minor postoperative complications was 3.1% with the majority of postoperative events comprising catheter-related problems (n = 161, 22.4%). Prolonged use of the catheter beyond 3 days is associated with a statistically significant increase in the frequency of skin infective/inflammatory changes (P <0.01). We highlight common complications and conundrums faced. Conclusion: Epidural analgesia has been shown to be associated with a relatively low risk of complications both in the adult and paediatric populations, albeit with a fourfold increased risk in the latter cohort. Adverse events reported are largely related to catheter problems and have minimal impact upon the patient. Key words: Anaesthesia, Analgesia, Child, Post-dural puncture headache

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“…There is a paucity of data on epidural analgesia in children. [ 2 ] Very few studies looked into the efficacy and complications of epidural analgesia, and the existing published ones are retrospective[ 3 4 ] in nature. Hence, we attempted a prospective observational study to assess the efficacy of epidural blocks with specific mention to the complications involved among children.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional observation study to evaluate the efficacy and complications of epidural analgesia in paediatric population

Thomas,

Bhasulamani,

James

et al. 2023

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: With advances in pediatric surgery, pediatric epidurals are increasingly being used for analgesia. As there is scarcity of data in India about the pediatric epidurals, we sought to determine the efficacy and complications of epidural analgesia. The aim of this study was to determine the efficacy of pediatric epidural analgesia and the incidence of complications aimed at improving the quality of care. Material and Methods: It was a prospective observational study in tertiary care hospital in the Southern part of India. Newborns to children aged 18 years in whom continuous epidural analgesia was planned were recruited. They were followed up postoperatively at specified intervals wherein pain scores were used to determine analgesic efficacy. Complications were noted in a specified format and the level of satisfaction of patient and surgeon was noted objectively. All the statistical analyses were performed using SPSS 25.0. Results: 100 children were recruited of which 63 received thoracic epidurals and 37 lumbar epidurals. Overall efficacy of epidural in pain management was 90.96% with the highest efficacy for lower abdominal epidurals (94.9%). Kinking of a catheter was the most common complication encountered (11%), followed by migration of catheter, occlusion of pump, and motor block. Conclusion: Continuous epidural analgesia has proven to be a safe and effective method to provide analgesia to the children in a protected environment and experienced hands.

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Safety of post-operative epidural analgesia in the paediatric population: A retrospective analysis

Cited by 13 publications

References 16 publications

Assessment of complications of epidural infusion analgesia in pediatric patients- A clinical study

Assessment of complications of epidural infusion analgesia in pediatric patients- A clinical study

An Audit of 829 Paediatric Epidurals in a Tertiary Singapore Hospital: Complications and Conundrums

A cross-sectional observation study to evaluate the efficacy and complications of epidural analgesia in paediatric population

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