Thomas Anu, Bhasulamani Smithamol Perumattom, James Deeptiman, Yadav Bijesh, Rai Ekta
Consultant Anaesthesiologist, Herbertpur Christian Hospital, Dehradun, Uttarakhand, India.
Department of Anaesthesia, Christian Medical College, Vellore, Tamilnadu, India.
J Anaesthesiol Clin Pharmacol. 2023 Apr-Jun;39(2):189-194. doi: 10.4103/joacp.joacp_218_21. Epub 2023 Jan 19.
With advances in pediatric surgery, pediatric epidurals are increasingly being used for analgesia. As there is scarcity of data in India about the pediatric epidurals, we sought to determine the efficacy and complications of epidural analgesia. The aim of this study was to determine the efficacy of pediatric epidural analgesia and the incidence of complications aimed at improving the quality of care.
It was a prospective observational study in tertiary care hospital in the Southern part of India. Newborns to children aged 18 years in whom continuous epidural analgesia was planned were recruited. They were followed up postoperatively at specified intervals wherein pain scores were used to determine analgesic efficacy. Complications were noted in a specified format and the level of satisfaction of patient and surgeon was noted objectively. All the statistical analyses were performed using SPSS 25.0.
100 children were recruited of which 63 received thoracic epidurals and 37 lumbar epidurals. Overall efficacy of epidural in pain management was 90.96% with the highest efficacy for lower abdominal epidurals (94.9%). Kinking of a catheter was the most common complication encountered (11%), followed by migration of catheter, occlusion of pump, and motor block.
Continuous epidural analgesia has proven to be a safe and effective method to provide analgesia to the children in a protected environment and experienced hands.
随着小儿外科手术的进展，小儿硬膜外麻醉越来越多地用于镇痛。由于印度关于小儿硬膜外麻醉的数据匮乏，我们试图确定硬膜外镇痛的疗效及并发症。本研究的目的是确定小儿硬膜外镇痛的疗效及并发症发生率，旨在提高护理质量。
这是一项在印度南部一家三级护理医院进行的前瞻性观察性研究。招募计划进行连续硬膜外镇痛的新生儿至18岁儿童。术后按特定间隔对他们进行随访，其中使用疼痛评分来确定镇痛效果。以特定格式记录并发症，并客观记录患者和外科医生的满意度。所有统计分析均使用SPSS 25.0进行。
共招募了100名儿童，其中63例接受胸段硬膜外麻醉，37例接受腰段硬膜外麻醉。硬膜外麻醉在疼痛管理方面的总体有效率为90.96%，下腹段硬膜外麻醉的有效率最高（94.9%）。导管打折是最常见的并发症（11%），其次是导管移位、泵堵塞和运动阻滞。
在有经验的人员操作的保护环境中，连续硬膜外镇痛已被证明是为儿童提供镇痛的一种安全有效的方法。
