Intervertebral epidural anesthesia in 2,050 infants and children using the drip and tube method

BACKGROUND AND OBJECTIVES: Pediatric epidural anesthesia has increased in popularity in the last 2 decades, but its success rate and the frequency of complications has not been fully elucidated. We therefore reviewed our experience with 2,050 cases of epidural anesthesia in infants and children. METHODS: We recorded the number of attempts at epidural space location, complications, and effectiveness in 2,050 cases of single-shot sacral intervertebral, lumbar, and thoracic epidural anesthesia. We used the drip and tube method for identification of the epidural space and administration of local anesthetic solution. RESULTS: The overall rate of successful epidural block and epidural space location on the first attempt was 96.4% and 89.8%, respectively. Complications included uncomplicated dural penetration (0.54%), spinal anesthesia (0.05%), bloody tap (0.34%), and intravascular injection (0.20%). Complications were more frequent in patients </=10 kg body weight. There were no permanent neurological sequelae. CONCLUSIONS: Intervertebral epidural anesthesia using the "drip and tube" method is safe and practical in infants and children.