Efficacy, safety and complication of epidural analgesia in pediatrics

Abstract

For managing different types of pain, epidural analgesia is widely used in adults. Its application in children is less common and subject to discussion. This article seeks to investigate the evidence concerning the efficacy, safety, and potential complications of analgesia in patients. We analyzed randomized controlled trials, observational studies, and systematic reviews that compared analgesia to pain management methods or placebo for children undergoing surgery or experiencing acute or chronic pain. The findings indicated that epidural analgesia effectively reduced pain intensity and opioid consumption in children undergoing types of surgeries—especially thoracic, abdominal, and orthopedic procedures. Epidural analgesia has also been proven to create satisfaction and improve the quality of life for children experiencing cancer pain or sickle cell crisis. The use of analgesia may result in some side effects, like itchiness, feelings of nausea, vomiting, difficulty urinating, and low blood pressure. Serious complications such as hematoma, infection, nerve damage, or respiratory depression were occurrences. Affected less than 1% of patients. In summary, we conclude that epidural analgesia is an option for pain management as it offers relief with minimal risk of significant complications. Nonetheless, further high-quality studies are required to compare techniques, medications, and dosages of analgesia, specifically in children, while also evaluating its long-term outcomes.