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Caudal Anaesthesia for Upper Abdominal Surgery in Infants and Children: A Simple Calculation of the Volume of Local Anaesthetic
Author(s) -
Satoyoshi M.,
Kamiyama Y.
Publication year - 1984
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1984.tb02011.x
Subject(s) - medicine , local anaesthetic , anesthesia , general anaesthesia , general anaesthetic , abdominal surgery , volume (thermodynamics) , surgery , physics , quantum mechanics
Where the use of non‐depolarizing muscle relaxants and antagonists is undesirable in infants and children undergoing abdominal surgery, caudal anaesthesia is frequently adopted, combined with light general anaesthesia. A simple calculation has been derived to determine the volume of local anaesthetic needed to obtain a higher effective anaesthetic level (up to T 4–5 ) for upper abdominal operations using caudal anaesthesia. Clinically, a linear correlation was found between an empirically injected volume of local anaesthetic and the distance from C7 to the sacral hiatus in 21 infants and children. A similar relationship was also demonstrated radiographically in 16 cadavers by studying the spread of radio‐opaque solution in the epidural space introduced by the caudal technique. From both statistical studies, a simple formula to determine the required volume of local anaesthetic for upper abdominal surgery was derived: V = D– 13, where V is the volume of local anaesthetic in ml and D is the distance from C 7 to the sacral hiatus in cm.