Document Detail


Major complications related to epidural analgesia in children: a 15-year audit of 3,152 epidurals.
MedLine Citation:
PMID:  23296493     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Complications associated with epidural analgesia in children have a reported incidence of 40-90 in 10,000 epidurals. We sought to determine the incidence of major complications with the use of continuous epidural analgesia that occurred in our centre over the past 15 years and to describe the nature of these complications. METHODS: The Acute Pain Service database at a tertiary care academic pediatric hospital was reviewed retrospectively over a 15-year period. Data were categorized according to patient age (neonate, infant, child one through eight years, and child > eight years), mode of insertion of the epidural (caudal, transsacral, lumbar, thoracic), complication type, and complication severity. RESULTS: Over the 15-year period, 3,152 epidurals were performed. The use of caudal-thoracic epidurals in neonates and infants has increased since 2007. Twenty-four major complications were identified (incidence, 7.6 in 1,000 epidurals). The rate of complications in neonates was 4.2% compared with 1.4% in infants, 0.5% in children aged one through eight years, and 0.8% in children over eight years of age. The two most common complications were local skin infection and drug error. CONCLUSIONS: Our incidence of major complications and our finding that complications were more common in neonates and infants are both consistent with previously published data. The two most common types of complications are potentially preventable.
Authors:
Gail K Wong; Abeer A Arab; Sue C Chew; Basem Naser; Mark W Crawford
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-8
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthesie     Volume:  -     ISSN:  1496-8975     ISO Abbreviation:  Can J Anaesth     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada, gail.wong@sickkids.ca.
Vernacular Title:
Complications majeures liées à l'analgésie péridurale chez les enfants: une analyse sur 15 ans de 3152 péridurales.
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