Abstract
INTRODUCTION: In this study we reviewed our experience with caudal epidural catheters in newborns with abdominal wall detects who were less than 48H (hours) of age.
Methods: After receiving HSPC approval, charts of 5 former newborns who underwent abdominal wall defect (gastroschesis and omphaloccele) repair were reviewed. Either a 20 or 24g catheter was inserted 3-6cm into the epidural space, via the caudal route. After a test dose of lidocaine an infusion of 0.5-2.0% lidocaine with 1-2mcg/ml of fentanyl was begun.
RESULTS: Results of the review are listed in Table 1. Five infants less than 48h of age weighing 1.92-2.70 kg had caudal epidural catheters placed easily. The catheters remained in situ for 3-20 days. No infections from the catheters occurred. Plasma lidocaine levels were <0.5-5.8 mcg/ml.
Discussion: No adverse effects to the local anesthetic or opiate were observed. The use of epidural infusions in neonates with abdominal wall defects provides a useful alternative to the standard sedation and paralysis currently used at our institution.
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Anderson, C., Barrett, C., Newman, A. et al. CAUDAL EPIDURAL REGIONAL ANESTHESIA AND ANALGESIA IN NEONATES WITH ABDOMINAL DEFECTS. Pediatr Res 35, 270 (1994). https://doi.org/10.1203/00006450-199402000-00097
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DOI: https://doi.org/10.1203/00006450-199402000-00097
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