Caudally threaded epidural catheter following a single-shot caudal block in a high-risk neonate: a combined caudal-epidural technique

Keys to minimizing the risk of spinal cord trauma during a lumbar approach to thoracic epidural

“…9,[14][15][16][17][18][19][20][21][22][23][24][25] In contrast, only a few case series and reports describing catheter threading from a lumbar insertion point have been published. 11,25 There are multiple reasons for the popularity of the caudal approach among pediatric anesthesiologists.…”

“…Des décennies plus tard, De nombreux comptes rendus, particulièrement dans la littérature d'anesthésie pédiatrique, rapportent la réussite de techniques d'insertion péridurale caudales et l'insertion du cathéter jusqu'aux niveaux thoracique et lombaire. 9,[14][15][16][17][18][19][20][21][22][23][24][25] En revanche, seules quelques séries de cas décrivant l'insertion d'un cathéter depuis un point d'insertion lombaire ont été publiées. 11,25 Les raisons pour la popularité de l'approche caudale avec les anesthésiologistes pédiatriques sont multiples.…”

Response to epidural anesthesia in neonates for pyloromyotomy and accompanying editorial

“…On the other hand, we feel that the editorialists go too far in their criticism and appear to question the practicality of many regional anesthetic techniques in infants. We have published two case reports describing modifications of the caudally threaded epidural catheter technique in two syndromic infants who required palliative surgeries and in whom it was requested that general anesthesia with endotracheal intubation be avoided (3,4). We therefore believe that there is definitely a role for advanced regional anesthesia techniques in infants and neonates and that the contributions of investigators such as Willschke are extremely important.…”