Epidural anesthesia - Its efficacy, safety and cardiovascular stability in children

Background: A child awaking without pain is much easier to manage than one who wakes with pain. Regional anesthesia is also useful when general anaesthesia is technically difficult or is associated with an increased morbidity and mortality. Aim: The present study was conducted to identify the efficacy, safety and cardiorespiratory stability under anesthesia in children undergoing various lower abdominal and lower limb surgeries. Materials and methods: The study consisted of sixty patients of either sex, aged 1 to 12 years undergoing lower abdominal and lower limb surgeries under epidural block. Group A patients were premedicated with Inj. Glycopyrrolate I/V 0.1 mg to 0.2 mg, Inj. Ketamine I/V in the dose of 1 mg/kg. Group B patients were premedicated with Inj. Glycopyrrolate I/V 0.1 mg to 0.2 mg and Inj. Diazepam I/V 2.5 mg to 5.0 mg or Inj. Thiopentone sodium I/V 2-3 mg/kg body weight. After per medicating the child was preloded with isolute P/Ringer lactate (5-7 ml/kg body weight) Results: The mean duration of analgesia in group A patients was 151.2±10.84 minutes and in group B it was 149.8±5.74 minutes. There was no significant effect of epidural block on cardiovascular system. In this study none of the cases showed any significant change in respiratory rate and oxygen saturation in both groups. Conclusion: Epidural anesthesia in children is quite safe, economical and effective method for lower abdominal and lower limb surgery. Cardio respiratory Stability is excellent with this technique. Patient wakes pain free after surgery is over child is much easier to manage