Loading...
Please wait, while we are loading the content...
Similar Documents
Thoracic and lumbar epidural analgesia via the caudal approach using electrical stimulation guidance in pediatric patients: a review of 289 patients.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Tsui, Ban C. H. Wagner, Alese Cave, Dominic A. Kearney, Ramona |
| Copyright Year | 2004 |
| Abstract | BACKGROUND Nerve stimulation guidance (Tsui test) has been reported to be an effective alternative to radiographic imaging for proper catheter placement. The purpose of this study was to examine the success rate and complications of continuous caudal epidural analgesia since the implementation of routine use of the Tsui test at the authors' institution. METHODS The authors examined prospectively collected data in their pediatric pain service database from 289 children who had attempted caudal placement of a lumbar or thoracic catheter between 1999 and 2002. RESULTS In five patients (aged 5 months-1.6 yr), the catheter did not thread to the desired level and was abandoned in the operating room (technical success rate, 98.2%). Of the remaining 284 patients, the overall analgesic success rate of all caudal route epidural analgesia procedures was 84.9%. There was no significant difference in adequate pain control (success) in infants (aged 1 day-1 yr) versus older children (aged younger than 1 yr). The most common adverse effects were pruritus (26.1%) and nausea and vomiting (16.9%). Of the patients in our study, 57.7% had urinary catheters in situ; of those who did not have a catheter placed, 20.8% experienced urinary retention. The incidence of respiratory depression was 4.2%, but the administration of naloxone for severe respiratory depression was never necessary. Three percent of catheters were removed because of suspected contamination, but no epidural abscesses or systemic infection were noted. CONCLUSIONS The results of this study suggest that epidural catheter placement via the caudal approach using the Tsui test is an effective and reasonable alternative to direct lumbar and thoracic epidural analgesia in pediatric patients. |
| Starting Page | 230 |
| Ending Page | 237 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://anesthesiology.pubs.asahq.org/pdfaccess.ashx?url=/data/journals/jasa/931201/0000542-200403000-00032.pdf |
| PubMed reference number | 15108986v1 |
| Volume Number | 100 |
| Issue Number | 3 |
| Journal | Anesthesiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Abscess Analgesia, Epidural Analgesics Attempt Caudal Chest Electric stimulation technique Naloxone Nausea and vomiting Nerve Tissue Operating Room Pain Patients Pruritus Respiratory Insufficiency Sepsis Urinary catheter Urologic Neoplasms |
| Content Type | Text |
| Resource Type | Article |
