[Training of epidural anesthesia with pressure-guided method in pediatric patients].

Epidural anesthesia in pediatric patients has become popular, and some useful techniques have been introduced. We use the pressure-guided method to identify the epidural space. This method enables us to visualize, on the monitor, the pressure change as the needle advances. With this method, we, including even a new resident in anesthesia, can identify the epidural space objectively and safely. A pressure transducer with saline-filled tubing is connected to a Tuohy needle. As the needle advances, the pressure rises gradually. As soon as the needle enters the epidural space, the pressure suddenly decreases and synchronizes with the heart beats. In the first 10 months after I started working as a resident in anesthesia, I performed 16 pediatric epidural anesthesias successfully under the direction of the anesthetic specialist. I would like to emphasize that I was able to perform epidural anesthesia safely at the thoracic level (T 11 x 12) even in the newborn (body weight 3400 g). The pressure-guided method enables us, even a new resident, to accomplish epidural anesthesia at thoracic level in newborn.