Open AccessCaudal anesthesia in a patient with peritonitis: Is it safe??
Author(s) -
Hiromi Kako,
Mohammed Hakim,
Anup Kumar Kundu,
J. D. Tobias
Publication year - 2016
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/1658-354x.168826
Subject(s) - medicine , neuraxial blockade , bacteremia , sepsis , anesthetic , anesthesia , blockade , intensive care medicine , peritonitis , anesthesiology , surgery , spinal anesthesia , antibiotics , receptor , microbiology and biotechnology , biology
Neuraxial anesthesia combined with general anesthesia has become a widely accepted method of providing effective postoperative analgesia and decreasing intraoperative anesthetic needs in the pediatric population. In clinical practice, there still appears to be hesitancy for the use of a neuraxial technique (spinal or epidural) in patients at risk for bacteremia or with an on-going systemic infection. However, evidence-based medicine lacks any data to support an increase in the risk of infectious complications following neuraxial anesthesia. We present two pediatric patients with intra-abdominal infectious processes who received caudal epidural blockade for postoperative operative analgesia. The use of neuraxial techniques in patients at risk for bacteremia is reviewed, evidence-based medicine regarding the risks of infection discussed, and the potential favorable effects of neuraxial blockade on the neurohumoral response to sepsis and the systemic inflammatory responses presented.