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Home Course Pediatric Epidural Anesthesia & Analgesia

Pediatric Epidural Anesthesia & Analgesia

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INTRODUCTION

Epidural analgesia is commonly used in addition to general anesthesia and to manage postoperative pain. Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, facilitating weaning from ventilators, reducing time spent in a catabolic state, and lowering circulating stress hormone levels.(1) Precise placement of epidural needles for single-injection techniques and catheters for continuous epidural anesthesia ensures that the dermatomes involved in the surgical procedure are selectively blocked, allowing for lower doses of local anesthetics to be used and sparing unnecessary blockade in nondesired regions. The approach to the epidural space can be at the caudal, lumbar, or thoracic level.

Course Content

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Anatomy and Physiological Implications
Local Anesthetics for Epidural Anesthesia in Children
Adjuvants for Epidural Anesthesia in Children 3 Topics
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Lesson Content
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Opioids
Clonidine
Ketamine
Complications Associated with Epidural Anesthesia 7 Topics
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Neurologic Injury
Epidural Hematoma
Infection
Dural Puncture and Postdural Puncture Headache
Hemodynamic Effects and Total Spinal Anesthesia
Local Anesthetic Systemic Toxicity
Other Adverse Effects
Epidural Blockade for Pediatric Surgery: Techniques 15 Topics
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Confirmation of Proper Epidural Needle or Catheter Placement
Aspiration and Test Dose
Radiographic Methods
Epidural Stimulation Test (Tsui Test) and Epidural ECG Technique
Ultrasound-Guided Techniques
Epidural Approaches
Caudal Epidural Analgesia: Single-Injection Technique
Choice of Needle for Caudal Analgesia
Technique for Performing a Single-Injection Caudal Epidural Block
Confirmation of Correct Local Anesthetic Distribution
Caudal Epidural Analgesia: Continuous Technique
Lumbar Epidural Anesthesia
Lumbar-to-Thoracic Epidural Approach
Thoracic Epidural Analgesia
Thoracic Epidural Analgesia: Midline Approach
Postoperative Epidural Infusion Management
References
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