PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ

Objective: In pediatric surgery, caudal epidural analgesia is reliable, easy to learn regional anesthesia technique in surgical procedures under the umbilicus. Despite its frequent use, excellent analgesic properties, current literature search yielded only a few large series reported. We aimed to present our institutional experience reflecting the collective data in pediatric urological surgical casesMateials and Methods: The anesthesia records of 5536 consecutive pediatric urological surgical cases who underwent caudal epidural anesthesia procedure between January 2008-February 2013 were retrospectively analyzed. Parameters including the type of surgery, demographic findings, need for additional analgesic agents, the complications related to the procedure, the percentage of failed cases were analyzed.Results: Total patients with a median age of 4 years were enrolled. There were 4538 male (82%), 998 female (18%) patients. In four cases the procedure was terminated due to dural puncture. Inadvertent penetration of vascular space was noted in 276 (4,98%) cases. In 221 cases, it was terminated due to the failure of correct placement of the needle despite repeated attempts. The procedure was categorized as failure in 122 (2,2%) cases. 4096 patients were discharged on the same day. In 48 patients (1,5%) additional analgesic dose was needed. In the patients who required prolonged hospitalization additional analgesic was started at postoperative 6th hour.Conclusion: Caudal epidural anesthesia is easy, safe and effective technique in preoperative and postoperative pain control.. The main advantages are high success, low complication rates, lesser analgesic dose requirement. In the light of our study results, we recommend routine use of the caudal epidural procedure in pediatric urological surgery cases