THE RISK OF INFECTION FROM EPIDURAL ANALGESIA IN CHILDREN - A REVIEW OF 1620 CASES

We reviewed cases to determine whether suspected or confirmed epidural infection was associated with epidural analgesia for 1620 infants, ch ildren, and adolescents treated over a 6-yr period at Children's Hospi tal, Boston. Postoperative patients (1458/1620) received epidural infu sions for a median of 2 days (range, 0-8 days). No postoperative patie nt had an epidural abscess. One 10-yr-old with terminal malignancy rec eived thoracic epidural analgesia via two successive catheters over a 4-wk period. She had Candida colonization of the epidural space along with necrotic epidural tumor. A second oncology patient and two patien ts with reflex sympathetic dystrophy were evaluated for epidural absce ss, but none was found. We conclude that the risk of epidural infectio n is quite low in pediatric postoperative patients receiving short-ter m catheterization. Use of prolonged epidural analgesia in the manageme nt of chronic pain in children requires careful monitoring of warning signs of infection.