Pediatric Neuraxial Anesthesia and Analgesia (preprint)

Abstract: Neuraxial anesthetic techniques are generally safe and effective in children of all ages. Spinal anesthesia may reduce the risk of early post-operative apnea in neonates and former premature infants and is an alternative to general anesthesia in resource-limited settings. Epidural anesthesia may facilitate early tracheal extubation in neonates and is a useful adjunct to multimodal analgesia to spare opioids and enhance recovery in the post-operative period. A large prospective study of >40,000 neuraxial anesthetics demonstrated the safety of epidural catheter placement in children under general anesthesia. Serious complications from pediatric neuraxial anesthesia are rare as demonstrated in case series and the Pediatric Regional Anesthesia Network database.