CASE REPORT

Continuous caudal analgesia as a safe and effective method for pediatric post - chordectomy analgesia

Tjokorda Gde Agung Senapathi , I Made Subagiartha, I Made Gede Widnyana, Putu Kurniyanta, Christopher Ryalino, Ronald Estrada

Tjokorda Gde Agung Senapathi
Department of Anesthesiology, Pain Management, and Intensive Care, Udayana University, Sanglah General Hospital, Denpasar – Bali, Indonesia. Email: tjoksenapathi@unud.ac.id

I Made Subagiartha
Department of Anesthesiology, Pain Management, and Intensive Care Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia

I Made Gede Widnyana
Department of Anesthesiology, Pain Management, and Intensive Care Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia

Putu Kurniyanta
Department of Anesthesiology, Pain Management, and Intensive Care Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia

Christopher Ryalino
Department of Anesthesiology, Pain Management, and Intensive Care Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia

Ronald Estrada
Department of Anesthesiology, Pain Management, and Intensive Care Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia
Online First: April 28, 2019 | Cite this Article
Senapathi, T., Subagiartha, I., Widnyana, I., Kurniyanta, P., Ryalino, C., Estrada, R. 2019. Continuous caudal analgesia as a safe and effective method for pediatric post - chordectomy analgesia. Bali Journal of Anesthesiology 3(1): 23-26. DOI:10.15562/bjoa.v3i1.113


ABSTRACT

It brings great satisfaction for medical officers to be able to see children smiling, laughing, and playing without pain after surgery, yet many children still experience inadequate postoperative pain management. This phenomenon could lead to serious immediate and long term effects in the pediatric patient. Disruption of the healing process caused by pain could become the source of morbidity and mortality in the early postoperative period. Opioid side effects and transformation from acute to chronic pain due to inadequate analgesia are other problems met when dealing with postoperative pain management. This is where regional analgesia takes advantage. Caudal analgesia is an old yet very popular method in pediatric anesthesia and has gained widespread use. It can be delivered as a single injection or continuous infusion. The continuous technique provides a longer duration of analgesia than single injection does. We report a satisfying result from using continuous caudal analgesia for post chordectomy pain management in a 5-year-old boy.

 

References

REFERENCES

Brasher C, Gafsous B, Dugue S, et al. Postoperative Pain Management in Children and Infants: An Update. Pediatr Drugs. 2014; 16(2): 129-40. DOI: 10.1007/s40272-013-0062-0.

Verghese ST, Hannallah RS. Acute pain management in children. J Pain Res. 2010; 3: 105-23. DOI: 10.2147/JPR.S4554.

Patel D. Epidural analgesia for children. CEACCP. 2006; 6(2):63-6. DOI: 10.1093/bjaceaccp/mk1001.

JÖhr M, Berger TM. Caudal blocks. Pediatr Anesth. 2012; 22(1): 44-50. DOI: 10.1111/j.1460-9592.2011.03669.x.

Raux O, Dadure C, Carr J, et al. Paediatric caudal anesthesia. Update in Anaesthesia. 2010; 26: 32-6. Available at: https://www.wfsahq.org/components/com_virtual_library/media/1787c84ded44a48928a47cfb0ce4f638-Paediatric-caudal-anaesthesia.pdf

Cicekcibasi AE, Borazan H, Ar1can S, et al. Where is the apex of the sacral hiatus for caudal epidural block in the pediatric population? A radio-anatomic study. J Anesth. 2014; 28(4): 569-75. DOI: 10.1007/s00540-013-1758-6.

Larousse E, Asehnoune K, Dartayet B, et al. The Hemodynamic Effects of Pediatric Caudal Anesthesia Assessed by Esophageal Doppler. Anesth Analg. 2002; 94(5): 1165-8. DOI: 10.1097/00000539-200205000-00020.

Baird R, Guilbault M-P, Tessier R, et al. A systematic review and meta-analysis of caudal blockade versus alternative analgesic strategies for pediatric inguinal hernia repair. J Pediatr Surg. 2013; 48(5): 1077-85. DOI: 10.1016/j.jpedsurg.2013.02.030.

Eu CS, Kumar SV, Ali S, et al. Sequestrated caudal catheter in a child: An anesthetic nightmare and surgical dilemma. Saudi J Anaesth. 2017; 11(1): 86-8. DOI: 10.4103/1658-354X.197333.

Bradford VA, Falcon RJ, Petersen TR, et al. Case Report of Delayed Post Caudal Catheter Placement pseudomeningocele. AA Pract. 2018; 10(10): 258-60. DOI: 10.1213/XAA.0000000000000679.

Verghese ST, Hannallah RS. Acute pain management in children. J Pain Res. 2010; 3: 105-23. DOI: 10.2147/JPR.S4554.

Bubeck J, Boos K, Krause H, et al. Subcutaneous Tunneling of Caudal Catheters Reduces the Rate of Bacterial Colonization to That of Lumbar Epidural Catheters. Anesth Analg. 2004; 99(3): 689-93. DOI: 10.1213/01.ANE.0000130023.48259.FB.

Morton NS. Local and regional anesthesia in infants. CEACCP. 2004; 4(5): 148-51. DOI: 10.1093/bjaceaccp/mkh041.

Maria BDJ, Tielens L, Roberts S. Pediatric Epidural and Spinal Anesthesia and Analgesia. Available at https://www.nysora.com/foundations-of-regional-anesthesia/sub-specialties/pediatric-anesthesia/ pediatric-epidural-spinal-anesthesia-analgesia. Accessed December 23, 2018

Lerman J, Nolan J, Eyres R, et al. Efficacy, safety, and pharmacokinetics of levobupivacaine with and without fentanyl after continuous epidural infusion in children: a multicenter trial. Anesthesiology. 2003; 99(5): 1166-74. Available at: https://www.ncbi.nlm.nih.gov/pubmed/14576555

BÖsenberg AT, Thomas J, Cronje L, et al. Pharmacokinetics and efficacy of ropivacaine for continuous epidural infusion in neonates and infants. Pediatr Anesth. 2005; 15(9):739-49. DOI: 10.1111/j.1460-9592.2004.01550.x.

Okonkwo I, Bendon AA, Cervellione RM, et al. Continuous Caudal Epidural Analgesia and Early Feeding in Delayed Bladder Exstrophy Repair: A 9-year experience. J Pediatr Urol. 2018. DOI: 10.1016/j.jpurol.2018.10.022.

Suresh S, Long J, Birmingham PK, et al. Are Caudal Blocks for Pain Control Safe in Children? An Analysis of 18,650 Caudal Blocks from the Pediatric Regional Anesthesia Network (PRAN) Database. Anesth Analg. 2015; 120(1):151-56. DOI: 10.1213/ANE.0000000000000446.


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