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LOCATION OF EPIDURAL SPACE WITH THE DRIP AND TUBE METHOD IN INFANTS WITH OR UNDER 10KG: AN EXPERIENCE OF 11 YEARS
ESRA Academy. Henriques Oliveira C. Sep 8, 2016; 138429; 0277 Topic: Paediatric Population
Catarina Nádia Henriques Oliveira
Catarina Nádia Henriques Oliveira

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Abstract
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Background and Aims:

Epidural anaesthesia or analgesia is an effective method of providing pain relief to children. The drip and tube method to locate the epidural space is described in literature as useful and reliable in infants. Several advantages over traditional loss of-resistance methods using air or saline are reported. We aimed to evaluate the effectiveness of this method in infants ≤ 10kg in our hospital, as well as associated complications.

Methods:

We retrospectively collected data from the medical records of all infants ≤ 10kg that underwent thoracic and lumbar single-shot or continuous epidural anaesthesia/analgesia over a period of 11 years, with the drip and tube method. Statistical analysis was performed with SPSS 22.0®.

Results:

266 patients were included (60.9% male and 39.1% female); age raging between 0.7 months and 48 months old (mean age 11.58 months ± 6.98); mean weight 8.27kg ± 1.99. ASA I: 47.4%; ASA II: 42.1%; ASA III: 10.5%. Thoracic epidural technique was performed in 13 patients (single-shot n=4; continuous n=9) and lumbar epidural technique in 253 patients (single-shot n=81; continuous n=172). 45.9% underwent urologic surgery; 36.8% gastrointestinal surgery; 15,4% orthopaedic surgery; 1.9% thoracic surgery. Overall insertion success rate of this method was 98,5% with 3 cases (1,1%) of inadvertent dural puncture and 1 case (0,4%) of intravascular catheter insertion. No other complications were reported. 

Conclusions:

In this study we show that the drip and tube method used to locate the epidural space is feasible and safe in infants ≤ 10kg, with a high success rate and relatively few complications.

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