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- W2045467501 abstract "Continuous caudal anesthesia via the sacral canal is a versatile and safe anesthesia method. This blockade should only be performed by fully trained anesthesiologists. When the sacral cornua hiatus is identified, the puncture must be done as cephalad as possible inside the sacral hiatus, and the appropriate needle must be advanced 2 to 3 cm. The catheter is measured with reference to the back from the end of the needle to the desired spinal level and is inserted to the appropriate length. A test dose of 2 to 3 mL of 0.25% bupivacaine with epinephrine 1:200,000 (5 μg/mL) is administered, followed by 0.5 to 0.75 mL/kg−1. Half of the initial dose can be given after about 120 minutes. A continuous infusion of 0.02 mg· kg−1· h−1 bupivacaine and fentanyl 0.5 μg·kg−1 · h−1 is used. The risk of clinical infection in the postoperative 24 to 48 hours is negligible. Epidural lumbar block can be performed between L3–L4 and T12–L1. The skin-epidural distance should be registered. The distance varies according to the approach angle. The epidural space can be identified by loss of resistance to air or saline. The catheter should not be advanced farther than 2 to 3 cm into the epidural space. The same dose as in caudal anesthesia is used. Epidural thoracic blockade should be reserved for analgesia after thoracic surgery. For this purpose it is performed at the midthoracic region, using both median and paramedian approaches. Usually the needle has to be inserted at an cephalad angulation of 70°. Bupivacaine 0.25% 0.25 mL · kg−1 (with epinephrine 1:200,000 is administered. When necessary, two more doses are injected. A continuous infusion of 0.02 mg · kg−1 · hr−1 bupivacaine and fentanyl 0.25 μg · kg−1 · hr−1 is used." @default.
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- W2045467501 date "1998-04-01" @default.
- W2045467501 modified "2023-09-27" @default.
- W2045467501 title "Continuous epidural anesthesia and analgesia in children" @default.
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- W2045467501 doi "https://doi.org/10.1016/s1084-208x(98)80013-x" @default.
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