Some vagaries of neonatal lumbar epidural anaesthesia

Regional anaesthesia and analgesia offer unique advantages of reduction in general anaesthesia requirements and the demands on NICU resources while im proving the general outcome. We assessed the feasibility of continuous lumb ar epidural analgesia in 20 neonates for various major surgical procedures lasting from 60-260 min. The babies were aged 18 h to 34 days. They were bo rn at a gestational age of 31-40 weeks. We had difficulty in passing the ep idural catheter from the lumbar route in two patients, so we had to resort to the caudal route. The problems associated with the placement of the cath eter from the lumbar route are discussed. The analgesia was provided for up to 72 h. Nineeteen of the babies could be extubated in the operating theat re. They were awake but comfortable at the time of extubation. There were n o complications due to the technique. Subsequent to this study, epidural an algesia either by lumbar or caudal route has become the routine in our hosp ital for all major thoraco-abdominal surgical procedures in neonates.