Department of Anesthesia, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail N.W., Calgary, AB, T3B 6A8, Canada,
Can J Anaesth. 2014 Jan;61(1):72-5. doi: 10.1007/s12630-013-0061-1. Epub 2013 Nov 19.
Francis G. Ruston MD CITATION: Ruston FG. Epidural anaesthesia in infants and children. Can Anaesth Soc J 1954: 1: 37-44.
The author describes the use of single-shot epidural anesthesia in a series of 44 infants and children. The patients were anesthetized in hospitals in Hamilton, Ontario from 1949 until the time of publication in 1954. The study aimed to describe the indications and efficacy of this technique as well as any apparent complications. A detailed description of the management of these patients was given, including many tips and suggestions that are still applicable in 2013.
Seventy-seven infants and children received epidural anesthesia for a variety of procedures, particularly for pyloric stenosis. Forty-four of the procedures were carried out by the author. All patients survived, apart from one child who died of recurrent intestinal obstruction unrelated to the anesthetic. It was found, after some experience, that the sitting position was preferable for epidural needle insertion. Use of the hanging drop technique for identification of the epidural space proved to be simple and reliable. Surgical conditions were found to be excellent and relaxation was profound; however, some sedation was often required to obtain optimal conditions for surgery. The surgeons became sold on the technique and began to request an epidural on a regular basis.
Epidural anesthesia in infants and young children is effective for a variety of procedures below the diaphragm, even in moribund patients.
弗朗西斯·G·拉斯顿医学博士
拉斯顿 FG. 婴儿和儿童的硬膜外麻醉。加拿大麻醉学会杂志 1954:1:37-44.
作者描述了在安大略省汉密尔顿的几家医院对 44 名婴儿和儿童进行单次硬膜外麻醉的情况。该研究旨在描述该技术的适应证和疗效，以及任何明显的并发症。对这些患者的管理进行了详细描述，包括许多在 2013 年仍适用的技巧和建议。
77 名婴儿和儿童因各种手术，特别是幽门狭窄，接受了硬膜外麻醉。其中 44 例手术由作者进行。除了一名死于与麻醉无关的复发性肠梗阻的儿童外，所有患者均存活。经过一些经验，发现作者更倾向于在坐姿下进行硬膜外针插入。使用悬滴技术来识别硬膜外间隙被证明是简单可靠的。手术条件被发现非常好，松弛程度很深；然而，为了获得最佳手术条件，通常需要一些镇静。外科医生对该技术非常满意，并开始定期要求硬膜外麻醉。
硬膜外麻醉在婴儿和幼儿中对于横膈以下的各种手术是有效的，即使在病危患者中也是如此。
