| A Clinical Observasion of Pediatric Caudal Anesthesia . |
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Byoung Moo Kim, Ji Hyoung Kim, Sook Ja Kim, Young Hyo Park, Dong Ki Lee |
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Department of Anesthesiology, Seoul Red Cross Hospital, Seoul, Korea. |
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| Abstract |
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Pediatric caudal anesthesia was done in 50 infants and children under 15 years of age, who were to undergo surgery of the inguinal region, urethra, perineum and lower extremity. All cases were given 1mg/kg body weight of 1% lidocaine solution with adrenaline 1: 200,000. The results were as follows: 1) Pediatric caudal anesthesia was simple, easy and reliable in technique and the success rate was high (94%). 2) There was one case of convulsion following lidocaine injection and it was treated immediately with thiopental, diazepam and ventilation with 100% oxygen. 3) As additional measure to provide a more cooperative state was need ed i.e. intravenous administration of 5mg/kg body weight of thiopental. 4) Anesthetic effect was judged satisfactory in 47 cases (84%). There was 2 poor anesthesia results and 1 failure. All 3 cases needed inhalation anesthesia. One failure was accidental intravenous injection of lidocaine solution. 5) The onset time of analgesia ranged from 1 to 5 minutes(average 2.5min.) after injection of lidocaine solution into sacral canal. 6) Complete analgesia was established 8~25 minutes(average 15.6min.) after injection of lidocain solution. Highest dermatome level of analgesia was T11-T4. 7) The duraion of analgesia, which was measured from maiximum analgesia to regression of analgesia of 2 dermatomes, ranged from 70 to 130 minutes(average 98.5 min.). 8) The average operation time was 70 minutes, so that pediatric caudal anesthesia is desirable in an operation lasting about 1 hour. 9) Cardiovascular and respiratory changes were minimal. 10) Theis anesthetic method was especially helpful in postoperative management because of continuous anal esic effect. From the above results, it my be concluded that caudal anesthesia in pediatric surgery is useful for the patients, anesthetists, surgeons, nurses and parents. |
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