EPIDURAL ANESTHESIA IN CHILDREN

Abstract

Paediatric central neuraxial blockade is a well-recognised and valuable technique for achieving perioperative and post-operative pain control. Lumbar and thoracic epidural insertion remain important modalities for pain control and when working effectively, are considered the gold standard for post-operative analgesia in children (1).   Evidence suggests that pain control is at least comparable and in many cases improved when compared with intravenous techniques (2). Epidurals provide optimal analgesia whilst avoiding opioid-related side effects, with studies demonstrating fewer episodes of hypoxaemia or respiratory depression and a reduced need for postoperative ventilation and intensive care (3). There is also greater haemodynamic stability, improved gastrointestinal function, less nausea and vomiting and a reduced neurohumeral stress response (4). It is worth remembering however that epidural opiates can also result in systemic complications.