European Journal of Cardiovascular Medicine

Epidural anesthesia has been used since many years it's only in the last two decades has its popularity increased in children and infants. But still there are unanswered questions with the technique.  Study was undertaken to evaluate the efficacy of epidural aaesthesia with 0.25%bupivcacine for lower abdominal surgeries. Methods: We evaluated the characteristics of epidural block including onset, duration of action, haemodynamic changes, ease of performance, efficacy, adverse effects and complication in 50 children aged between 4 to 14 years. Local ethical committee approved the protocol of this prospective study and parents gave written informed consent. Uncooperative patients were sedated with either ketamine or inhalational agents. Epidural block was performed in lateral position with 19G Tuohy's needle in L4-L5 space and 19 G epidural catheter was threaded after detecting the ES by LOR technique. The dose of 0.25% bupivacaine was age in years/10 per spinal segment (> 10 yrs) and I ml/kg up to 20ml (< 10 years). Results: Efficacy, safety and ease of performance were satisfactory in most children. Onset of action being 13-15 min and the duration ranged between 60-90 min. 2 cases needed to be supplemented with GA. Incidence and severity of complications was low. 7 patients developed shivering and 2 developed vomiting. Conclusion:  Epidural  anesthesia with  0.25%  hyperbaric bupivacaine  in  the appropriate dosage is a safe technique in pediatric patients undergoing lower abdominal surgeries.