Continuous epidural analgesia for post-operative pain relief in paediatric patients

Abstract

The safety of epidural analgesia in paediatric patients has been well established. It was used as a single shot technique for intra and immediate post-operative pain relief, which helped to reduce the requirement of potent opiate analgesics with their attendant unwanted side effects. There was some initial hesitation in using continuous epidural techniques by placing a catheter in paediatric population because of the fear of local anaesthetic systemic toxicity (LAST) and the immaturity of enzyme systems of the liver to metabolize the local anaesthetic agents, especially in neonates and pre-maturely born infants.[1] Several studies and review papers have proved this fear to be unfounded, and no serious complications have been encountered in practice. Hence, the exclusion of neonates and infants from receiving this continuous technique for post-operative pain relief is no longer advocated.